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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2023; 58(01): 085-091
DOI: 10.1055/s-0042-1750073
Artigo Original
Joelho

Relationship of the Cruciate and Meniscofemoral Ligaments with the Knee Osteology. An Anatomical Study[*]

Article in several languages: português | English
Fernando Corbi-Aguirre 
1   Cirurgia Ortopédica e Traumatologia, Faculdade de Medicina, Universidade CEU-San Pablo, Madrid, Espanha
,
Francisco Forriol 
1   Cirurgia Ortopédica e Traumatologia, Faculdade de Medicina, Universidade CEU-San Pablo, Madrid, Espanha
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Abstract

Objective To analyze the dimensions of the posterior cruciate ligament (PCL), anterior cruciate ligament (ACL), the presence of meniscus-femoral ligaments MFLs in human knees, and the correlation with the dimensions of the knee skeleton.

Methods Anatomical study on 29 specimens of human knees in which we measured the length and width of the cruciate and meniscus-femoral ligaments and the dimensions of femoral and tibia condyles and the femoral notch. The ACL length was calculated with different degrees of knee flexion. The relationship between the ligaments and bone dimensions were analyzed.

Results The length of the ACL and the PCL were similar. Posterior MFL was more frequent and longer than the anterior MFL. We found the posterior MFL in the 72.41% of the knees and anterior MFL in 20.69%. The ACL presented 30% of its maximum length up to 60°, approximately half of its length between 90° and 120°, reaching its maximum length at 170°. We found a strong correlation between the length of the ACL and that of the PCL (p = 0.001). However, the lengths of the ACL and PCL were not related with the bone dimensions.

Conclusion We have found no correlations between the cruciate and MFLs and the anatomical dimensions of the intercondylar notch and the proximal tibia and distal femur. The presence of the posterior MFL was more frequent and longer than that of the anterior ligament.

Keywords

knee - anterior cruciate ligament - posterior cruciate ligament - meniscus

Financial Support

There was no financial support from public, commercial, or non-profit sources.


* Study carried out in the School of Medicine, University CEU-San Pablo, Madrid, Spain.




Publication History

Received: 22 November 2021

Accepted: 28 April 2022

Article published online:
24 March 2023

© 2023. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • Referências

  • 1 Amis AA, Gupte CM, Bull AM, Edwards A. Anatomy of the posterior cruciate ligament and the meniscofemoral ligaments. Knee Surg Sports Traumatol Arthrosc 2006; 14 (03) 257-263
    Search in Google Scholar
  • 2 Greiner P, Magnussen RA, Lustig S, Demey G, Neyret P, Servien E. Computed tomography evaluation of the femoral and tibial attachments of the posterior cruciate ligament in vitro. Knee Surg Sports Traumatol Arthrosc 2011; 19 (11) 1876-1883
    Search in Google Scholar
  • 3 Takahashi M, Matsubara T, Doi M, Suzuki D, Nagano A. Anatomical study of the femoral and tibial insertions of the anterolateral and posteromedial bundles of human posterior cruciate ligament. Knee Surg Sports Traumatol Arthrosc 2006; 14 (11) 1055-1059
    Search in Google Scholar
  • 4 Ahmad CS, Cohen ZA, Levine WN, Gardner TR, Ateshian GA, Mow VC. Codominance of the individual posterior cruciate ligament bundles. An analysis of bundle lengths and orientation. Am J Sports Med 2003; 31 (02) 221-225
    Search in Google Scholar
  • 5 Papannagari R, DeFrate LE, Nha KW. et al. Function of posterior cruciate ligament bundles during in vivo knee flexion. Am J Sports Med 2007; 35 (09) 1507-1512
    Search in Google Scholar
  • 6 Amadi HO, Gupte CM, Lie DT, McDermott ID, Amis AA, Bull AM. A biomechanical study of the meniscofemoral ligaments and their contribution to contact pressure reduction in the knee. Knee Surg Sports Traumatol Arthrosc 2008; 16 (11) 1004-1008
    Search in Google Scholar
  • 7 Bao HR, Zhu D, Gong H, Gu GS. The effect of complete radial lateral meniscus posterior root tear on the knee contact mechanics: a finite element analysis. J Orthop Sci 2013; 18 (02) 256-263
    Search in Google Scholar
  • 8 Pula DA, Femia RE, Marzo JM, Bisson LJ. Are root avulsions of the lateral meniscus associated with extrusion at the time of acute anterior cruciate ligament injury?: a case control study. Am J Sports Med 2014; 42 (01) 173-176
    Search in Google Scholar
  • 9 Osti M, Tschann P, Künzel KH, Benedetto KP. Anatomic characteristics and radiographic references of the anterolateral and posteromedial bundles of the posterior cruciate ligament. Am J Sports Med 2012; 40 (07) 1558-1563
    Search in Google Scholar
  • 10 Racanelli JA, Drez Jr D. Posterior cruciate ligament tibial attachment anatomy and radiographic landmarks for tibial tunnel placement in PCL reconstruction. Arthroscopy 1994; 10 (05) 546-549
    Search in Google Scholar
  • 11 Moorman III CT, Murphy Zane MS, Bansai S. et al. Tibial insertion of the posterior cruciate ligament: a sagittal plane analysis using gross, histologic, and radiographic methods. Arthroscopy 2008; 24 (03) 269-275
    Search in Google Scholar
  • 12 Edwards A, Bull AM, Amis AA. The attachments of the anteromedial and posterolateral fibre bundles of the anterior cruciate ligament. Part 2: femoral attachment. Knee Surg Sports Traumatol Arthrosc 2008; 16 (01) 29-36
    Search in Google Scholar
  • 13 Ramos LA, de Carvalho RT, Cohen M, Abdalla RJ. Anatomic relation between the posterior cruciate ligament and the joint capsule. Arthroscopy 2008; 24 (12) 1367-1372
    Search in Google Scholar
  • 14 Makris CA, Georgoulis AD, Papageorgiou CD, Moebius UG, Soucacos PN. Posterior cruciate ligament architecture: evaluation under microsurgical dissection. Arthroscopy 2000; 16 (06) 627-632
    Search in Google Scholar
  • 15 Race A, Amis AA. PCL reconstruction. In vitro biomechanical comparison of ‘isometric’ versus single and double-bundled ‘anatomic’ grafts. J Bone Joint Surg Br 1998; 80 (01) 173-179
    Search in Google Scholar
  • 16 Pearsall IV AW, Hollis JM. The effect of posterior cruciate ligament injury and reconstruction on meniscal strain. Am J Sports Med 2004; 32 (07) 1675-1680
    Search in Google Scholar
  • 17 Covey DC, Sapega AA, Marshall RC. The effects of varied joint motion and loading conditions on posterior cruciate ligament fiber length behavior. Am J Sports Med 2004; 32 (08) 1866-1872
    Search in Google Scholar
  • 18 Markolf KL, Feeley BT, Jackson SR, McAllister DR. Biomechanical studies of double-bundle posterior cruciate ligament reconstructions. J Bone Joint Surg Am 2006; 88 (08) 1788-1794
    Search in Google Scholar
  • 19 Bergfeld JA, McAllister DR, Parker RD, Valdevit AD, Kambic H. The effects of tibial rotation on posterior translation in knees in which the posterior cruciate ligament has been cut. J Bone Joint Surg Am 2001; 83 (09) 1339-1343
    Search in Google Scholar
  • 20 Grood ES, Hefzy MS, Lindenfield TN. Factors affecting the region of most isometric femoral attachments. Part I: The posterior cruciate ligament. Am J Sports Med 1989; 17 (02) 197-207
    Search in Google Scholar
  • 21 Gupte CM, Smith A, Jamieson N, Bull AM, Thomas RD, Amis AA. Meniscofemoral ligaments–structural and material properties. J Biomech 2002; 35 (12) 1623-1629
    Search in Google Scholar
  • 22 Kusayama T, Harner CD, Carlin GJ, Xerogeanes JW, Smith BA. Anatomical and biomechanical characteristics of human meniscofemoral ligaments. Knee Surg Sports Traumatol Arthrosc 1994; 2 (04) 234-237
    Search in Google Scholar
  • 23 Poynton AR, Javadpour SM, Finegan PJ, O'Brien M. The meniscofemoral ligaments of the knee. J Bone Joint Surg Br 1997; 79 (02) 327-330
    Search in Google Scholar
  • 24 Yamamoto M, Hirohata K. Anatomical study on the menisco-femoral ligaments of the knee. Kobe J Med Sci 1991; 37 (4-5): 209-226
    Search in Google Scholar
  • 25 Coulier B. Signification of the unusual delineation of the anterior meniscofemoral ligament of Humphrey during knee arthro-CT. Surg Radiol Anat 2009; 31 (02) 121-128
    Search in Google Scholar
  • 26 Anderson CJ, Ziegler CG, Wijdicks CA, Engebretsen L, LaPrade RF. Arthroscopically pertinent anatomy of the anterolateral and posteromedial bundles of the posterior cruciate ligament. J Bone Joint Surg Am 2012; 94 (21) 1936-1945
    Search in Google Scholar
  • 27 Gupte CM, Bull AM, Thomas RD, Amis AA. A review of the function and biomechanics of the meniscofemoral ligaments. Arthroscopy 2003; 19 (02) 161-171
    Search in Google Scholar
  • 28 Amis AA, Bull AM, Gupte CM, Hijazi I, Race A, Robinson JR. Biomechanics of the PCL and related structures: posterolateral, posteromedial and meniscofemoral ligaments. Knee Surg Sports Traumatol Arthrosc 2003; 11 (05) 271-281
    Search in Google Scholar
  • 29 Hassine D, Feron JM, Henry-Feugeas MC, Schouman-Claeys E, Guérin Surville H, Frija G. The meniscofemoral ligaments: magnetic resonance imaging and anatomic correlations. Surg Radiol Anat 1992; 14 (01) 59-63
    Search in Google Scholar
  • 30 Kaplan EB. The lateral meniscofemoral ligament of the knee joint. Bull Hosp Jt Dis 1956; 17 (02) 176-182
    Search in Google Scholar
  • 31 Lahlaidi A, Vaclavek J. [The posterior menisco-femoral ligaments and their significance in organogenesis]. Bull Assoc Anat (Nancy) 1975; 59 (164) 177-183
    Search in Google Scholar
  • 32 Le Minor JM. Comparative morphology of the lateral meniscus of the knee in primates. J Anat 1990; 170: 161-171
    Search in Google Scholar
  • 33 Han SH, Kim DI, Choi SG, Lee JH, Kim YS. The posterior meniscofemoral ligament: morphologic study and anatomic classification. Clin Anat 2012; 25 (05) 634-640
    Search in Google Scholar