Posterolateral Corner of the Knee: Microsurgical Analysis of Anatomy and Morphometry

Abstract

Reconstruction of the posterolateral corner (PLC) of the knee is essential to restore knee joint function. Controversy exists regarding a standardized nomenclature, the connective attachments and the relationships between them, and the frequency of occurrence among all structures of the PLC. Thirty human cadaveric knee specimens were investigated. The lateral collateral ligament, popliteus tendon, popliteofibular ligament, fabellofibular ligament, arcuate ligament, oblique popliteal ligament, posterior meniscofemoral ligament, and popliteal hiatus (including the popliteomeniscal ligaments) were studied. The length, diameter, variations, course, and morphology of these structures, as well as the position and dimension of the insertion, were measured and referenced the footprints to adjacent bony landmarks. Compared with existing studies, the lateral collateral ligament footprint was more proximal to the lateral femoral epicondyle (average, 3.61 ± 0.75 mm) and the popliteus tendon insertion was more distal and anterior to the lateral collateral ligament footprint (average, 5.69 ± 1.36 mm and 4.97 ± 1.73 mm, respectively). Only minor data have been published on the fabellofibular ligament (average length, 33.79 ± 4.98 mm; average diameter, 4.04 ± 1.22 mm), arcuate ligament (average length, 31.54 ± 2.82 mm; average diameter, 7.27 ± 1.56 mm), oblique popliteal ligament (average length, 45.56 ± 4.67 mm; average diameter, 14.90 ± 4.67 mm), posterior meniscofemoral ligament (average length, 23.75 ± 3.17 mm; average diameter, 3.62 ± 1.03 mm), and popliteomeniscal ligaments (average mediolateral popliteal hiatus diameter, 9.83 ± 2.16 mm; average superoinferior popliteal hiatus diameter, 8.23 ± 1.86 mm).

A morphometric study of the popliteus myotendinous complex with its clinical aspects

“…The mean length and width of the popliteus tendon in present study was 35.12 mm and 9.52 mm, respectively. This is almost similar to most of the previous studies (15,16). The length of popliteal tendon in present study was found to be shorter than that reported by Kurtoglu et al (17).…”

Morphological Features of the Popliteus Tendon, Popliteofibular and Lateral (Fibular) Collateral Ligaments

“…Our finding about the length of LCL was similar to previous studies, as shown in Table II (Maynard et al, 1996;Ishigooka et al, 2004;Espregueira-Mendes & da Silva;Zhang et al, 2009;Jung et al;Osti et al). In most of the cases, LCL was wider at the upper part and narrower at the lower part, in accordance with the findings of Takeda et al In these literatures, width of LCL was given from the midportion or at the level of articular line.…”

“…Additionally, inconsistency in nomenclature of the ligamentous structures of the region (the fabellofibular ligament, arcuate popliteal ligament (AL) and PF) makes the area more difficult to cope with. The discrepancies for these ligaments have already been tried to be clarified by several authors and also the authors of previously presented study (Seebacher et al, 1982;Osti et al, 2013& Kurtoglu et al, 2015. For the PLC injuries, many reconstruction techniques have been published in the literature (Djian;Jung et al;Niki et al, 2012& Minowa et al, 2005.…”

Surgical Management of the Multiple‐Ligament Injured Knee: a Case Series from Chongqing, China and Review of Published Reports

“…Therefore, the reported incidence of MLIK was far greater than the morbidity of knee dislocation, especially in Chongqing, China. Although this observation may appear rudimentary, in the authors’ experience the primary reason for failure of surgical treatment of cruciate and collateral ligaments injuries is unrecognized posteromedial or posterolateral lesions, and this failure to diagnose and evaluate properly can result in a host of complications.…”