Anatomic Consideration of Nerve Supply to the Vastus Medialis in Knee Surgery

Jôjima, Hiroshi; Whiteside, Leo A.; Ogata, Kosuke

doi:10.1097/01.blo.0000128642.61260.b3

Cited by 26 publications

(19 citation statements)

References 11 publications

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“…They reported that in 45% of their pathological cohort one nerve branch was identified, whereas two branches were identified in 55% of their cohort. On further analysis, these differences in innervation were significantly correlated with the degree of Javadpour et al (1991) 15/15 1 in 100 Jojima et al (2004) 10/10 1 in 100 Lefebvre et al (2006) 17/39 1 in 44 22/39 2 in 56 Lieb and Perry (1968) 5/6 1 in 83 1/6 2 in 17 Nozic et al (1997) 50/50 2 in 100 Ono et al (2005) 2/2 2 in 100 Özer et al (2004) 20/20 2 in 100 Peeler et al (2005) 32/32 1 in 100 Thiranagama (1990) 30/30 2 in 100 Toumi et al (2007) 10/10 2 in 100 Weinstabl et al (1989) 115/115 1 in 100 a Studies assessing pathological knees. patellofemoral cartilaginous damage.…”

Section: Innervationmentioning

confidence: 91%

“…The presence of a fascial plane dividing the VMO and the VML may indicate a structural basis for the division of the VM into two discrete components (Javadpour et al, 1991;Travnik et al, 1995). Furthermore, a specific innervation to the VML and VMO muscles may theoretically allow the VML and VMO to exhibit different contraction onset timings (Lieb and Perry, 1971;Terry, 1989;Glenn and Samojla, 2002;Jojima et al, 2004). These factors have provided some evidence to hypothesize that the VMO and VML are separate muscles, citing that muscles with different anatomical architecture exhibit different functional roles (Blazevich et al, 2006).…”

Section: Introductionmentioning

confidence: 94%

“…As the VML and VMO are positioned in series, any force developed by the proximal VML must be transmitted to the distal VMO. This questions the notion that the VMO and VML can be independent muscles (Nozic et al, 1997;Jojima et al, 2004;Peeler et al, 2005) and may account for why electromyographic (EMG) studies have been unable to show a substantial isolated contraction of the VMO from the VML (Reynolds et al, 1983;Souza and Gross, 1991;Makhsous et al, 2004;Rainoldi et al, in press). Other authors have questioned the frequency of an abrupt change in muscle fiber orientation and innervation along the length of the VM, suggesting that a fibrofascial plane is an anatomical exception (Galtier et al, 1995;Barbaix and Pouders, 2005).…”

Section: Introductionmentioning

confidence: 95%

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Do the vastus medialis obliquus and vastus medialis longus really exist? A systematic review

et al. 2008

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There remains controversy over whether the vastus medialis (VM) is a single anatomical structure or whether it is composed of two separate portions, the vastus medialis longus (VML) proximally and the vastus medialis obliquus (VMO) distally. The objective of this study was to assess the evidence base of investigations into muscle fiber orientation, presence of a fibrofascial plane, and the innervation of the VM in human cadaver specimens and subjects. In addition to a hand search of specialist journals, an electronic search of AMED, British Nursing Index, CINAHL, the Cochrane database, EMBASE, ovid Medline, Pubmed, and Zetoc were performed from their inception to September 2008. All human subject papers assessing VM fiber orientation, presence of a fibrofascial plane, and the innervation of the VM where reviewed. Twenty-six papers, assessing 699 healthy knees, and 591 specimens with patellofemoral dysfunction were reviewed. The majority of nonpathological and pathological cases presented with a substantial alteration in fiber alignment seen between proximal and distal muscle portions of VM. Both cohorts presented with either one or two nerve branches to the VM. A fibrofascial plane dividing these two muscles was seen in a small proportion of both pathological and nonpathological knees. There was, however, insufficient good quality evidence to state whether the VM is composed of two separate components, the proximal VML and the distal VMO. Further study is recommended to evaluate the pathophysiological implications of such findings and to assess whether these correlate to functional electromyographic findings between the VML and VMO muscles.

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Section: Innervationmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 95%

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Do the vastus medialis obliquus and vastus medialis longus really exist? A systematic review

et al. 2008

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“…It is also an extensive approach, which may be used in revision total knee replacements where the extensor mechanism is preserved along with the vascularity and innervation to the vastus medialis. 3,4 Fig . 5 After adequate capsular exposure, arthrotomy is to be performed protecting the quadriceps tendon and vastus medialis.…”

Section: Discussionmentioning

confidence: 99%

“…1) as described by Jojima et al is an underrecognized approach to the anterior aspect of the knee that spares the vastus medialis by entering the knee at the junction between the quadriceps tendon and vastus medalis. 3 It is simple to perform, extensile (compatible with maneuvers such as a quadriceps snip if required), and easily repaired at the end of the case. 4 In this article, we describe a modified intervastus approach to the knee that ensures preservation of the quadriceps tendon and vastus medialis.…”

mentioning

confidence: 99%

Modified Intervastus Approach to the Knee

Sartawi¹,

Kohlman

Valle

2017

J Knee Surg

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The modified intervastus approach to the anterior knee is an approach that may be used in the majority of patients undergoing total knee arthroplasty. This article presents the first description of this approach. The advantages of this approach include its extensile nature, similar to a medial parapatellar approach, and preservation of the extensor mechanism and the vastus medialis, leading to a more rapid return to active knee extension than is traditionally observed. The approach is also simple to perform, easy to close, and is compatible with more extensile approaches such as a quadriceps snip if required in revision scenarios.

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