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Purpose The pes anserinus (PA) is characterized by high morphological diversity. As the semitendinosus and gracilis muscle tendons are routinely harvested for the reconstruction of other tendons, especially the anterior cruciate ligament (ACL), it is of clinical importance. The presence of accessory bands within PA tendons can handicap the harvesting process. Therefore, the purpose of the study was to suggest a new morphological classification of the PA morphology. Methods Classical anatomical dissection was performed on 102 lower limbs (56 right, 46 left) fixed in 10% formalin solution. The morphology and insertion of the PA (including accessory bands) were assessed, and morphometric measurements were taken. Results In all cases, the PA was present and composed of the sartorius, gracilis and semitendinosus tendons. Six types of PA were distinguished based on the presence of accessory bands. The most common composed of monotendinous sartorius, gracilis and semitendinosus—54 limbs (52.9%). Additionally, three types of insertion were noted (short, band-shaped and fan-shaped). The mean length between the insertion and the origin of the accessory bands to the fascia of the gastrocnemius muscle was 63.5 mm. Conclusion The morphology of the PA was highly variable. The gracilis and semitendinosus tendons often had accessory bands that would complicate the harvesting process. The planning of surgical procedures may be improved by our proposed classification. Electronic supplementary material The online version of this article (10.1007/s00167-018-5318-3) contains supplementary material, which is available to authorized users.

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The anterolateral ligament (ALL) is a potential stabilizer of the knee and cooperates with the anterior cruciate ligament (ACL). It originates on the lateral epicondyle of the femur, to which it is mainly posterior and proximal; insertion is posterior to Gerdy's tubercle. Its anatomical characteristics vary. Recent publications have focused on morphological variations concerning mainly the femoral and tibial attachments, and on morphometric measurements. Histological and cystochemical examinations have also been performed. Classical anatomical dissection was performed on 111 lower limbs (25 isolated and 86 paired) fixed in 10% formalin. The knee region was dissected using traditional techniques and the morphological features of the ALL were assessed: morphometric measurements and the types of ALL. The ALL was present in 70 individuals (37 woman and 33 men). In 30 cases, it was absent symmetrically, and in 11, it was present on just one side (P = 0.0011). The ALL was morphologically very variable. In type I (the most common form - 64.3%), a single band traveled parallel to the fibular collateral ligament (FCL); in type II the band crossed it. In type III, the origin was located on the lateral epicondyle of the femur and also on the lateral-posterior surface of the joint capsule, and the insertion was in the deep fascia of the leg: this type could be called a capsule. Type IV was characterized by a double ALL, type IIb by ligaments that bifurcated, and type V by the ALL starting directly from the FCL rather than the femoral epicondyle. The ALL is characterized by high morphological variability, both in its femoral and in its tibial attachments and in its course. Clin. Anat. 31:966-973, 2018. © 2018 Wiley Periodicals, Inc.

The body is home to a number of unique and intriguing anatomical structures, plenty of which concern the muscles and their tendons. Of these, the plantaris muscle is reported to present a particularly high range of morphological variations. The muscle, passing distally throughout the length of the lower leg, consists of a small muscle belly and a long, thin tendon. It originates, traditionally, on the popliteal surface of the femur and the knee joint capsule, and then inserts to the calcaneal tuberosity. It has been suggested that mid-portion Achilles tendinopathy may be caused by certain plantaris tendon morphologies. This case report describes a new anomalous plantaris tendon insertion, closely related to the Achilles tendon. It comprise four distinct insertions and one direct merge with the calcaneal tendon. The current classification should be extended to accommodate such 'rare cases' to facilitate more successful Achilles tendinopathy treatment.