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Macroscopic anatomical, histological and magnetic resonance imaging correlation of the lateral capsule of the knee

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The objective of the present study was to correlate macroscopic and microscopic anatomy of the lateral capsule of the knee joint with high-quality magnetic resonance imaging (MRI), with a hypothesis that a distinct lateral capsular ligament would be inconsistently observed via surgical dissection and that high-quality MRI imaging would correlate to findings from dissection.

Methods

Ten fresh-frozen human cadaveric knee specimens were utilized for this study. MRI of each knee was obtained pre- and post-dissection. The lateral knee was dissected and analysed for the presence or absence of a discrete capsular thickening or an independent ligamentous structure. A musculoskeletal radiologist analysed the pre- and post-dissection MRI. Subsequently, two specimens with positive lateral capsular thickening were prepared for histology.

Results

On macroscopic dissection, none of the ten specimens were found to have a discrete lateral capsular ligament. A palpable macroscopic thickening of the lateral capsule was identified in 4/10 specimens. MRI analysis revealed a 2–4 mm thickening of the central third of the lateral capsule in 3/10 specimens. On histological analysis, the lateral capsular thickening demonstrated properties similar to both capsule and ligament.

Conclusions

In fresh-frozen cadaveric specimens, macroscopic and MRI evaluation of the lateral capsule of the knee revealed variations in morphology without consistent capsuloligamentous anatomy and specifically no discrete lateral capsular ligament. Further investigation in the form of clinical and mechanical relevance of the lateral capsular structures is of paramount importance before limited anatomical data can be utilized to drive clinical decision-making and patient care.

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References

  1. Anderson AF, Snyder RB, Lipscomb AB Jr (2001) Anterior cruciate ligament reconstruction. A prospective randomized study of three surgical methods. Am J Sports Med 29(3):272–279

    CAS  PubMed  Google Scholar 

  2. Bignozzi S, Zaffagnini S, Lopomo N, Martelli S, Iacono F, Marcacci M (2009) Does a lateral plasty control coupled translation during antero-posterior stress in single-bundle ACL reconstruction? An in vivo study. Knee Surg Sports Traumatol Arthrosc 17(1):65–70

    Article  PubMed  Google Scholar 

  3. Caterine S, Litchfield R, Johnson M, Chronik B, Getgood A (2014) A cadaveric study of the anterolateral ligament: re-introducing the lateral capsular ligament. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-014-3117-z

    Google Scholar 

  4. Claes S, Luyckx T, Vereecke E, Bellemans J (2014) The segond fracture: a bony injury of the anterolateral ligament of the knee. Arthroscopy 30(11):1475–1482

    Article  PubMed  Google Scholar 

  5. Claes S, Vereecke E, Maes M, Victor J, Verdonk P, Bellemans J (2013) Anatomy of the anterolateral ligament of the knee. J Anat 223(4):321–328

    Article  PubMed  PubMed Central  Google Scholar 

  6. Dietz GW, Wilcox DM, Montgomery JB (1986) Segond tibial condyle fracture: lateral capsular ligament avulsion. Radiology 159(2):467–469

    Article  CAS  PubMed  Google Scholar 

  7. Dodds AL, Halewood C, Gupte CM, Williams A, Amis AA (2014) The anterolateral ligament: anatomy, length changes and association with the segond fracture. Bone Jt J 96(3):325–331

    Article  Google Scholar 

  8. Goldman AB, Pavlov H, Rubenstein D (1988) The segond fracture of the proximal tibia: a small avulsion that reflects major ligamentous damage. AJR Am J Roentgenol 151(6):1163–1167

    Article  CAS  PubMed  Google Scholar 

  9. Hughston JC, Andrews JR, Cross MJ, Moschi A (1976) Classification of knee ligament instabilities. Part I. The medial compartment and cruciate ligaments. J Bone Jt Surg Am 58(2):159–172

    CAS  Google Scholar 

  10. Hughston JC, Andrews JR, Cross MJ, Moschi A (1976) Classification of knee ligament instabilities. Part II. The lateral compartment. J Bone Jt Surg Am 58(2):173–179

    CAS  Google Scholar 

  11. Johnson LL (1979) Lateral capsular ligament complex: anatomical and surgical considerations. Am J Sports Med 7(3):156–160

    Article  CAS  PubMed  Google Scholar 

  12. Kennedy JC, Stewart R, Walker DM (1978) Anterolateral rotatory instability of the knee joint. An early analysis of the Ellison procedure. J Bone Jt Surg Am 60(8):1031–1039

    CAS  Google Scholar 

  13. LaPrade RF (1997) Arthroscopic evaluation of the lateral compartment of knees with grade 3 posterolateral knee complex injuries. Am J Sports Med 25(5):596–602

    Article  CAS  PubMed  Google Scholar 

  14. LaPrade RF, Gilbert TJ, Bollom TS, Wentorf F, Chaljub G (2000) The magnetic resonance imaging appearance of individual structures of the posterolateral knee. A prospective study of normal knees and knees with surgically verified grade III injuries. Am J Sports Med 28(2):191–199

    CAS  PubMed  Google Scholar 

  15. LaPrade RF, Terry GC (1997) Injuries to the posterolateral aspect of the knee. Association of anatomic injury patterns with clinical instability. Am J Sports Med 25(4):433–438

    Article  CAS  PubMed  Google Scholar 

  16. Last JR (1948) Some anatomical details of the knee joint. J Bone Jt Surg Br 30:683–688

    Google Scholar 

  17. Pernin J, Verdonk P, Si Selmi TA, Massin P, Neyret P (2010) Long-term follow-up of 24.5 years after intra-articular anterior cruciate ligament reconstruction with lateral extra-articular augmentation. Am J Sports Med 38(6):1094–1102

    Article  PubMed  Google Scholar 

  18. Pomajzl R, Maerz T, Shams C, Guettler J, Bicos J (2014) A review of the anterolateral ligament of the knee: current knowledge regarding its incidence, anatomy, biomechanics, and surgical dissection. Arthroscopy. doi:10.1016/j.arthro.2014.09.010

    PubMed  Google Scholar 

  19. Segond P (1879) Recherches cliniques et expérimentales sur les épanchements sanguins du genou par entorse. Progrès Med 7:297–341

    Google Scholar 

  20. Stijak L, Bumbasirevic M, Radonjic V, Kadija M, Puskas L, Milovanovic D, Filipovic B (2014) Anatomic description of the anterolateral ligament of the knee. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-014-3422-6

    Google Scholar 

  21. Terry GC, LaPrade RF (1996) The posterolateral aspect of the knee. Anatomy and surgical approach. Am J Sports Med 24(6):732–739

    Article  CAS  PubMed  Google Scholar 

  22. Vieira EL, Vieira EA, da Silva RT, Berlfein PA, Abdalla RJ, Cohen M (2007) An anatomic study of the iliotibial tract. Arthroscopy 23(3):269–274

    Article  PubMed  Google Scholar 

  23. Vincent JP, Magnussen RA, Gezmez F, Uguen A, Jacobi M, Weppe F, Al-Saati MF, Lustig S, Demey G, Servien E, Neyret P (2012) The anterolateral ligament of the human knee: an anatomic and histologic study. Knee Surg Sports Traumatol Arthrosc 20(1):147–152

    Article  PubMed  Google Scholar 

  24. Warren RF, Marshall JL (1978) Injuries of the anterior cruciate and medial collateral ligaments of the knee. A long-term follow-up of 86 cases–part II. Clin Orthop Relat Res 136:198–211

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Pittsburgh, 3200 South Water Street, Pittsburgh, PA, USA

    Malcolm E. Dombrowski, Bruno Ohashi, Christopher D. Murawski, Benjamin B. Rothrauff, Fabio V. Arilla, Nicole A. Friel, Freddie H. Fu, Richard E. Debski & Volker Musahl

  2. Department of Radiology, University of Pittsburgh, Pittsburgh, PA, USA

    Joanna M. Costello

  3. Department of Bioengineering, University of Pittsburgh, UPMC Center for Sports Medicine, 3200 South Water Street, Pittsburgh, PA, USA

    Richard E. Debski & Volker Musahl

Authors
  1. Malcolm E. Dombrowski
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  2. Joanna M. Costello
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  3. Bruno Ohashi
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  4. Christopher D. Murawski
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  5. Benjamin B. Rothrauff
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  6. Fabio V. Arilla
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  7. Nicole A. Friel
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  8. Freddie H. Fu
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  9. Richard E. Debski
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  10. Volker Musahl
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Corresponding author

Correspondence to Nicole A. Friel.

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Dombrowski, M.E., Costello, J.M., Ohashi, B. et al. Macroscopic anatomical, histological and magnetic resonance imaging correlation of the lateral capsule of the knee. Knee Surg Sports Traumatol Arthrosc 24, 2854–2860 (2016). https://doi.org/10.1007/s00167-015-3517-8

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  • DOI: https://doi.org/10.1007/s00167-015-3517-8

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