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Willinger L. - One of the best experts on this subject based on the ideXlab platform.
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Unique myological changes associated with ossified fabellae: a femorofabellar ligament and systematic review of the double-headed Popliteus
'PeerJ', 2020Co-Authors: Berthaume M. A., Barnes S., Athwal K.k., Willinger L.Abstract:The fabella is a sesamoid bone embedded in the tendon of the lateral head of the gastrocnemius. It is the only bone in the human body to increase in prevalence in the last 100 years. As the fabella can serve as an origin/insertion for Muscles, tendons, and/or ligaments (e.g., the oblique popliteal and fabellofibular ligaments), temporal changes in fabella prevalence could lead to temporal changes in “standard” knee anatomy. The aim of this study was to investigate unique myological changes to the posterolateral corner knee associated with ossified fabella presence and perform a systematic review to contextualize our results. Methods Thirty-three fresh frozen cadaveric knees were considered. As the knees were all used for previous experimentation, the knees were in variable levels of preservation. Those with adequate preservation were used to determine ossified fabella presence/absence. When ossified fabellae were present, unique myologies associated with the fabella were recorded. A systematic review was performed on the double-headed Popliteus to investigate possible correlations between this anatomical variant and the fabella. Results Of the 33 knees, 30 preserved enough soft tissue to determine fabella presence/absence: 16/30 knees had fabellae (five cartilaginous and 11 ossified). Eight of the eleven knees with ossified fabellae retained enough soft tissue to investigate the posterolateral knee anatomy. Of these, 4/8 exhibited unique myological changes. One knee had a double-headed Popliteus Muscle where one head originated from the medial side of a large, bulbous fabella. A systematic review revealed double-headed Popliteus Muscles are rare, but individuals are 3.7 times more likely to have a fabella if they have a double-headed Popliteus. Another knee had a large, thick ligament stretching from the lateral edge of the fabella to the inferoposterior edge of the lateral femoral epicondyle, deep to the lateral collateral ligament (LCL) and near the popliteal sulcus. We found no mention of such a ligament in the literature and refer to it here as the “femorofabellar ligament”. In all four knees, the plantaris and lateral gastrocnemius appeared to share a common tendinous origin, and the fabella was located at/near the junction of these Muscles. In the case of the double-headed Popliteus, the fabella clearly served as an origin for the plantaris. Conclusions Despite being found in an average of 36.80% of human knees, most standard anatomical models fail to account for the fabella and/or the unique myological changes associated with fabella presence. Although our sample is small, these data highlight aspects of human biological variability generally not considered when creating generalized anatomical models. Further work is needed to identify additional changes associated with ossified fabellae and the functional consequences of omitting these changes from models
Bertrand Sonnerycottet - One of the best experts on this subject based on the ideXlab platform.
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the arcuate ligament revisited role of the posterolateral structures in providing static stability in the knee joint
Knee Surgery Sports Traumatology Arthroscopy, 2014Co-Authors: Mathieu Thaunat, Charles Pioger, R Chatellard, J Conteduca, A Khaleel, Bertrand SonnerycottetAbstract:To determine the involvement of the posterolateral structures including the lateral collateral ligament, the Popliteus Muscle–tendon unit, the arcuate ligament (popliteofibular ligament, fabellofibular ligament, popliteomeniscal fascicles, capsular arm of short head of the biceps femoris and anterolateral ligament) and the posterior cruciate ligament in providing restraint to excessive recurvatum, tibial posterior translation and external tibial rotation at 90° of flexion. Ten fresh-frozen cadaveric knees were tested with dial test, posterior drawer test and recurvatum test. The values were collected, using a surgical navigation system, on intact knees, following a serial section of the posterolateral corner (lateral collateral ligament, arcuate ligament and Popliteus Muscle–tendon unit), followed by the additional section of the posterior cruciate ligament. The mean tibial external rotation, recurvatum and posterior drawer were, respectively, measured at 9° ± 4°, 2° ± 3° and 9 ± 1 mm on intact knees. These values increase to 12° ± 5°, 3° ± 2° and 9 ± 1 mm after cutting the lateral collateral ligament; 17° ± 6° (p < 0.05), 3° ± 2° and 10 ± 1 mm after sectioning the arcuate ligament; 18° ± 7°, 3° ± 2° and 10 ± 1 mm after sectioning the Popliteus Muscle–tendon unit and 27° ± 6° (p < 0.05), 5° ± 3° (p < 0.05) and 28 ± 2 mm (p < 0.05) after the additional section of the posterior cruciate ligament. Among the different structures of the posterolateral corner, only the arcuate ligament has a significant role in restricting excessive primary and coupled external rotation. The Popliteus Muscle–tendon unit is not a primary static stabilizer to tibial external rotation at 90° of knee flexion. The posterior cruciate ligament is the primary restraint to excessive recurvatum and posterior tibial translation. The posterior cruciate ligament and the arcuate ligament have predominant role for the posterolateral stability of the knee. The functional restoration of these ligaments is an important part of the surgical treatment of posterolateral ligamentous injuries.
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the arcuate ligament revisited role of the posterolateral structures in providing static stability in the knee joint
Knee Surgery Sports Traumatology Arthroscopy, 2014Co-Authors: Mathieu Thaunat, Charles Pioger, R Chatellard, J Conteduca, A Khaleel, Bertrand SonnerycottetAbstract:Purpose To determine the involvement of the posterolateral structures including the lateral collateral ligament, the Popliteus Muscle–tendon unit, the arcuate ligament (popliteofibular ligament, fabellofibular ligament, popliteomeniscal fascicles, capsular arm of short head of the biceps femoris and anterolateral ligament) and the posterior cruciate ligament in providing restraint to excessive recurvatum, tibial posterior translation and external tibial rotation at 90° of flexion.
Berthaume M. A. - One of the best experts on this subject based on the ideXlab platform.
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Unique myological changes associated with ossified fabellae: a femorofabellar ligament and systematic review of the double-headed Popliteus
'PeerJ', 2020Co-Authors: Berthaume M. A., Barnes S., Athwal K.k., Willinger L.Abstract:The fabella is a sesamoid bone embedded in the tendon of the lateral head of the gastrocnemius. It is the only bone in the human body to increase in prevalence in the last 100 years. As the fabella can serve as an origin/insertion for Muscles, tendons, and/or ligaments (e.g., the oblique popliteal and fabellofibular ligaments), temporal changes in fabella prevalence could lead to temporal changes in “standard” knee anatomy. The aim of this study was to investigate unique myological changes to the posterolateral corner knee associated with ossified fabella presence and perform a systematic review to contextualize our results. Methods Thirty-three fresh frozen cadaveric knees were considered. As the knees were all used for previous experimentation, the knees were in variable levels of preservation. Those with adequate preservation were used to determine ossified fabella presence/absence. When ossified fabellae were present, unique myologies associated with the fabella were recorded. A systematic review was performed on the double-headed Popliteus to investigate possible correlations between this anatomical variant and the fabella. Results Of the 33 knees, 30 preserved enough soft tissue to determine fabella presence/absence: 16/30 knees had fabellae (five cartilaginous and 11 ossified). Eight of the eleven knees with ossified fabellae retained enough soft tissue to investigate the posterolateral knee anatomy. Of these, 4/8 exhibited unique myological changes. One knee had a double-headed Popliteus Muscle where one head originated from the medial side of a large, bulbous fabella. A systematic review revealed double-headed Popliteus Muscles are rare, but individuals are 3.7 times more likely to have a fabella if they have a double-headed Popliteus. Another knee had a large, thick ligament stretching from the lateral edge of the fabella to the inferoposterior edge of the lateral femoral epicondyle, deep to the lateral collateral ligament (LCL) and near the popliteal sulcus. We found no mention of such a ligament in the literature and refer to it here as the “femorofabellar ligament”. In all four knees, the plantaris and lateral gastrocnemius appeared to share a common tendinous origin, and the fabella was located at/near the junction of these Muscles. In the case of the double-headed Popliteus, the fabella clearly served as an origin for the plantaris. Conclusions Despite being found in an average of 36.80% of human knees, most standard anatomical models fail to account for the fabella and/or the unique myological changes associated with fabella presence. Although our sample is small, these data highlight aspects of human biological variability generally not considered when creating generalized anatomical models. Further work is needed to identify additional changes associated with ossified fabellae and the functional consequences of omitting these changes from models
Mathieu Thaunat - One of the best experts on this subject based on the ideXlab platform.
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the arcuate ligament revisited role of the posterolateral structures in providing static stability in the knee joint
Knee Surgery Sports Traumatology Arthroscopy, 2014Co-Authors: Mathieu Thaunat, Charles Pioger, R Chatellard, J Conteduca, A Khaleel, Bertrand SonnerycottetAbstract:To determine the involvement of the posterolateral structures including the lateral collateral ligament, the Popliteus Muscle–tendon unit, the arcuate ligament (popliteofibular ligament, fabellofibular ligament, popliteomeniscal fascicles, capsular arm of short head of the biceps femoris and anterolateral ligament) and the posterior cruciate ligament in providing restraint to excessive recurvatum, tibial posterior translation and external tibial rotation at 90° of flexion. Ten fresh-frozen cadaveric knees were tested with dial test, posterior drawer test and recurvatum test. The values were collected, using a surgical navigation system, on intact knees, following a serial section of the posterolateral corner (lateral collateral ligament, arcuate ligament and Popliteus Muscle–tendon unit), followed by the additional section of the posterior cruciate ligament. The mean tibial external rotation, recurvatum and posterior drawer were, respectively, measured at 9° ± 4°, 2° ± 3° and 9 ± 1 mm on intact knees. These values increase to 12° ± 5°, 3° ± 2° and 9 ± 1 mm after cutting the lateral collateral ligament; 17° ± 6° (p < 0.05), 3° ± 2° and 10 ± 1 mm after sectioning the arcuate ligament; 18° ± 7°, 3° ± 2° and 10 ± 1 mm after sectioning the Popliteus Muscle–tendon unit and 27° ± 6° (p < 0.05), 5° ± 3° (p < 0.05) and 28 ± 2 mm (p < 0.05) after the additional section of the posterior cruciate ligament. Among the different structures of the posterolateral corner, only the arcuate ligament has a significant role in restricting excessive primary and coupled external rotation. The Popliteus Muscle–tendon unit is not a primary static stabilizer to tibial external rotation at 90° of knee flexion. The posterior cruciate ligament is the primary restraint to excessive recurvatum and posterior tibial translation. The posterior cruciate ligament and the arcuate ligament have predominant role for the posterolateral stability of the knee. The functional restoration of these ligaments is an important part of the surgical treatment of posterolateral ligamentous injuries.
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the arcuate ligament revisited role of the posterolateral structures in providing static stability in the knee joint
Knee Surgery Sports Traumatology Arthroscopy, 2014Co-Authors: Mathieu Thaunat, Charles Pioger, R Chatellard, J Conteduca, A Khaleel, Bertrand SonnerycottetAbstract:Purpose To determine the involvement of the posterolateral structures including the lateral collateral ligament, the Popliteus Muscle–tendon unit, the arcuate ligament (popliteofibular ligament, fabellofibular ligament, popliteomeniscal fascicles, capsular arm of short head of the biceps femoris and anterolateral ligament) and the posterior cruciate ligament in providing restraint to excessive recurvatum, tibial posterior translation and external tibial rotation at 90° of flexion.
Robert F Laprade - One of the best experts on this subject based on the ideXlab platform.
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A proposal for a new morphological classification of the Popliteus Muscle tendon with potential clinical and biomechanical significance
'Springer Science and Business Media LLC', 2021Co-Authors: Łukasz Olewnik, Robert F Laprade, Friedrich Paulsen, Bartosz Gonera, Konrad Kurtys, Michał Podgórski, Paloma Aragonés, Ramón J. Sanudo, Michał PolgujAbstract:Abstract The purpose of this study was to characterize the morphological variations in the proximal attachments and create an accurate classification of the PPM for use in planning surgical procedures in this area, for evaluating radiological imaging and rehabilitation. One hundred and thirty-four lower limbs of body donors (52 woman and 82 man) fixed in 10% formalin solution were examined. The Popliteus Muscle was present in all 134 limbs. Four main types were identified with subtypes. The most common type was Type I (34.3%), characterized by a single tendon in the Popliteus sulcus. Type II (30.6%) characterized by a main tendon in the Popliteus sulcus and accessory bands. This type was divided into five subtypes (A–E) based on presence of specific accessory bands. Type III (15.3%) was characterized by two tendons in the popliteal sulcus. Type IV (19.4%) was characterized by two tendons in the Popliteus sulcus and additional bands. This type was also divided into five subtypes (A–E) based on presence of specific accessory bands. The popliteofibular ligament was present in 90.3% of cases. A new classification based on a proximal attachment is proposed. The Popliteus tendon is characterized by a very high morphological variability, which can affect posterolateral knee stability and the natural rotation of the tibia. Such a classification system may be useful for clinicians performing medical procedures within the knee joint, including orthopedic surgeons
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corrigendum anatomical characteristics and biomechanical properties of the oblique popliteal ligament
Scientific Reports, 2017Co-Authors: Tao Zou, Robert F Laprade, Wei Wang, Wei Huang, Shanquan SunAbstract:Scientific Reports 7: Article number: 42698; published online: 16 February 2017; updated: 10 April 2017 This Article contains an error in the Discussion section. “Even so, there remains an area without external support between the OPL, the expansion over the Popliteus Muscle, and the lateral side ofthe posterior cruciate ligament, which are strongly related to the formation of popliteal cysts”.
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the posterolateral aspect of the knee anatomy and surgical approach
American Journal of Sports Medicine, 1996Co-Authors: Glenn C Terry, Robert F LapradeAbstract:Thirty cadaveric knees were dissected to obtain a de tailed understanding of the anatomic structures of the posterolateral aspect of the knee, and a dependable surgical approach to evaluate injuries to these struc tures was developed and used on 71 consecutive pa tients who were operated on for posterolateral knee injuries. Three fascial incisions and one lateral midcap sular incision were used to provide surgical access. The following individual anatomic structures were iden tified : the layers of the iliotibial tract, long and short heads of the biceps femoris Muscle, fibular collateral ligament, midthird lateral capsular ligament, fabello fibular ligament, posterior arcuate ligament, Popliteus Muscle complex, lateral coronary ligament, and poste rior capsule. This study increased our understanding of the individual anatomic structures and the relationships between these components. The surgical approach provided for the evaluation of these anatomic struc tures should aid the surgeon in properly assessi...