Morphometry of the fibular collateral ligament: Anatomic study with comprehensive review of the literature

Abstract

There is no consensus in the literature related to the morphology, bony attachments, and variations of the fibular collateral ligament (FCL) of the knee. Our purpose was to investigate FCL morphology and to review reports in the literature regarding this structure. Seventy knees from formalin-fixed, adult cadavers were dissected and a digital caliper was used to measure FCL length, width, distance from proximal attachment to articular surface (PA→AS), and distance from distal attachment to articular surface (DA→AS). The mean (SE) length and width of all FCLs was 48.3 (1.1) mm and 4 (0.16) mm, respectively. The mean (SE) PA→AS and DA→AS of all FCLs was 22 (0.8) mm and 24.8 (1) mm, respectively. We found a direct relationship between the PA→AS and DA→AS distances (Spearman rho = 0.527, P = 0.002) and this association was independent of age and sex. Two FCL variations were found: a bifurcate ligament with two distal bands and a trifurcate ligament with three distal bands, all of which attached to the fibular head. Our literature review revealed that only 2/10 cadaveric FCL morphology studies reported variations similar to the current study. Further, there was variability in the reported location of the FCL proximal attachment. When combining our data with these studies, 105/219 FCLs directly attached to the apex of the lateral epicondyle (LE), 10/219 to a fovea posterior to the LE, and 104/219 posterior and proximal to the LE. These data may have implications related to FCL injury and repair.

Highly Variable Femoral Morphology in Osteoarthritic Chinese: Are Prostheses Today Sufficiently Suitable?

“…lateral epicondylar prominence, 8,13 which were registered on a 3D model and reconfirmed on CT imaging. 14 Notably, the lateral prominence was further adjusted according to the attachment of the fibular collateral ligament, which could be observed anterodistally to the fovea of the gastrocnemius muscle.…”

“…14 Notably, the lateral prominence was further adjusted according to the attachment of the fibular collateral ligament, which could be observed anterodistally to the fovea of the gastrocnemius muscle. 13,15 A standard coronal plane β was made perpendicular to plane α, parallel to SEA, and flush with the anterior border of the distal femoral cortices, which represented the ideal anterior cut with no notching. 16 Points L and M were defined as the most posterior point on the medial and lateral posterior condyles, respectively, and the line connecting these two points was the PCL, which might be in a different plane with the SEA (►Fig.…”

Case report of a bifurcated fibular (lateral) collateral ligament: which band is the dominant one?

“…It is located within the lateral aspect of the knee and originates, traditionally, on the lateral epicondyle of the femur. It then runs distally and attaches to the lateral surface of the head of the fibula [3,17,28]. There is no connection between it and the knee joint capsule [3].…”

“…It then runs distally and attaches to the lateral surface of the head of the fibula [3,17,28]. There is no connection between it and the knee joint capsule [3]. The biomechanical functions of the FCL are well known and the most important of them is to resist varus forces.…”

Endoscopic Curettage of Bone Cyst of the Fibular Head

“… 1 The lateral collateral ligament, popliteofibular ligament, and biceps femoris tendon insert to the distal side of the lateral aspect of the fibular head, posterior aspect of the fibular styloid process, and lateral aspect of the fibular head surrounding the lateral collateral ligament, respectively. 1 , 2 The common peroneal nerve runs distally along the posterior border of the biceps femoris tendon and across the lateral cortex of the fibular neck. 3 For excision of an intramedullary lesion of the fibular head and neck, a safe zone is observed in the anterior half of the proximal 20 mm of the fibula head that would avoid injury to the peroneal nerve.…”