2021 ISAKOS Biennial Congress ePoster
The Menisco-Tibio-Popliteus-Fibular Complex: Anatomical Description Of The Structures That Could Avoid Lateral Meniscal Extrusion
Àngel Masferrer-Pino, MD PhD, Barcelona SPAIN
Ivan Saenz-Navarro, MD, Barcelona, Barcelona SPAIN
Gonzalo Rojas Castillo, MD, Talca CHILE
Simone Perelli, MD,PhD, Barcelona SPAIN
Juan Ignacio Erquicia, MD, PhD, Sant Pere De Ribes SPAIN
Pablo E. Gelber, MD, PhD, Barcelona SPAIN
Joan Carles Monllau, MD, PhD, Prof., Esplugues de Llobregat, Barcelona SPAIN
HOSPITAL UNIVERSITARI DEXEUS - ICATME, BARCELONA, BARCELONA, SPAIN
FDA Status Not Applicable
Summary
This study contributes to the understanding of the lateral meniscus body attachments and the functions they serve. This would lead to improvements in the treatment of lesions in this region as well as the development of surgical techniques for its pathologies.
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Abstract
Purpose
To analyze, quantify and redefine the anatomy of the peripheral attachments of the lateral meniscus body to further understand how the structures might play a part in preventing meniscal extrusion and how it might be applied to surgical techniques.
Methods
Ten non-paired fresh-frozen cadaveric knees without prior injury, a surgical history or gross anatomic abnormality were analyzed. There were five right knees and 5 left knees and 50% were from males and 50% from females. All the dissections were performed by a group of three experts in knee surgery (two knee surgeons and one anatomy professor who oversaw the designing of and guided the dissection protocol). The main peripheral structures associated with the lateral meniscus body were dissected. This was done to determine the insertion, size, thickness and location of the lateral menisco-tibial ligament (LMTL), the popliteo-fibular ligament (PFL) and the popliteo-meniscal ligament (PML). The distance to various landmarks in the lateral compartment was also determined using an electronic caliper. Moreover, a histopathological study was carried out.
Results
The average thickness (mm) of the LMTL was 0.62 +/- 0.18 (0.49 - 0.75) and 1.05 +/- 0.27 (0.85 - 1.24) for the PFL/PML area. The anteroposterior distance (mm) of the LMTL was 15.80 +/- 4.80 (12.40 - 19.30) and 10.40 +/- 1.70 (9.21 - 11.63) for the PFL/PML area. The anteroposterior distance (mm) of the whole menisco-tibio-popliteus-fibular complex (MTPFC) was 28.20 +/- 4.95 (24.70 - 31.70). The average distance (mm) from the MTPFC to the posterior horn of the lateral meniscus (PHLM) root was 29.30 +/- 2.29 (27.60 - 30.90) and 32.00 +/- 4.80 (28.60 - 35.50) for the anterior horn (AHLM). The average distance (mm) from the tibial insertion of LMTL to the articular surface was 5.59 +/- 1.22 (4.72 - 6.46). In all the anatomical components of the knee, a consistent morphological and histological pattern was observed between the fibers of the LMTL, PFL and PML and those of the lateral meniscus body, making up the proposed MTPFC.
Conclusions
A consistent anatomical pattern has been identified between the lateral meniscus body and the LMTL, PFL and PML, forming an interconnected complex that would seem appropriate to denominate the MTPFC. A precise study of this region and appropriate nomenclature for it could contribute to a better understanding of the mechanism of lateral meniscus injuries at this level as well as the development of surgical techniques to treat these lesions and prevent extrusion