A Recess Is Observed Between the Posterior Knee Capsule and the Meniscotibial Ligament Complex in Pediatric Specimens

Aleksei B. Dingel B.S. , Marc Tompkins M.D. , Yi-Meng Yen M.D. , Alexander K. Karius B.S. , Mark Cinque M.D. , Brian B. Vuong B.S. , Vanessa Taylor B.S. , Nicole S. Pham M.P.H. , Theodore J. Ganley M.D. , Philip Wilson M.D. , Henry B. Ellis M.D. , Daniel Green M.D. , Peter D. Fabricant M.D. , Laura Boucher Ph.D., A.T., A.T.C. , Kevin G. Shea M.D.
{"title":"A Recess Is Observed Between the Posterior Knee Capsule and the Meniscotibial Ligament Complex in Pediatric Specimens","authors":"Aleksei B. Dingel B.S. ,&nbsp;Marc Tompkins M.D. ,&nbsp;Yi-Meng Yen M.D. ,&nbsp;Alexander K. Karius B.S. ,&nbsp;Mark Cinque M.D. ,&nbsp;Brian B. Vuong B.S. ,&nbsp;Vanessa Taylor B.S. ,&nbsp;Nicole S. Pham M.P.H. ,&nbsp;Theodore J. Ganley M.D. ,&nbsp;Philip Wilson M.D. ,&nbsp;Henry B. Ellis M.D. ,&nbsp;Daniel Green M.D. ,&nbsp;Peter D. Fabricant M.D. ,&nbsp;Laura Boucher Ph.D., A.T., A.T.C. ,&nbsp;Kevin G. Shea M.D.","doi":"10.1016/j.asmr.2023.100852","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><p>To define the surgical anatomy of the meniscotibial ligament complex of the pediatric medial and lateral menisci and their relation to the proximal tibial physis and posterior joint capsule.</p></div><div><h3>Methods</h3><p>Fourteen pediatric cadaveric knee specimens (aged 3 months to 11 years) were dissected to clarify the relation of the posterior knee capsule, the meniscus, and the meniscotibial ligament complex. Metallic markers were placed marking the meniscotibial ligament capsular attachment on the proximal tibia. Specimens underwent computed tomography scanning to evaluate pin placement and relation to the physis. A digital measurement tool was used to measure the distances between the proximal tibial physis and the pins (placed at 5 points on both the lateral and medial menisci).</p></div><div><h3>Results</h3><p>In each specimen, clear separation was noted between the posterior joint capsule from the meniscus and meniscotibial ligament complex in the medial and lateral compartments. There was an increase in the distance between the proximal tibial physis and the insertion points of the meniscotibial ligament complex with increasing specimen age. For both the medical and lateral menisci in group 1, the median meniscotibial ligament insertion points were often less than 7 mm (interquartile range, 0.00-7.8 mm) away from the physis. The median meniscotibial ligament insertion points in group 2 tended to be farther from the physis but always less than 20 mm (interquartile range, 2.5-17.5 mm)—and as close as less than 5 mm (lateral posterior root).</p></div><div><h3>Conclusions</h3><p>In this anatomic study of pediatric knees, we observed a distinct recess/cul-de-sac space between the posterior knee capsule and meniscal attachments in all specimens. This defines a distinct plane between the posterior knee capsule and the meniscotibial ligament complex, with a distance between the physis and meniscotibial ligament capsular attachments that increases with age.</p></div><div><h3>Clinical Relevance</h3><p>The anatomic parameters evaluated in our study should be considered as future meniscal repair and transplantation techniques aim to restore the meniscal anatomy, stability, and mobility provided by the meniscotibial ligament complex and capsule structures.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X23002031/pdfft?md5=71371e6005b407433a3f3d79f4906d75&pid=1-s2.0-S2666061X23002031-main.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arthroscopy Sports Medicine and Rehabilitation","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666061X23002031","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0

Abstract

Purpose

To define the surgical anatomy of the meniscotibial ligament complex of the pediatric medial and lateral menisci and their relation to the proximal tibial physis and posterior joint capsule.

Methods

Fourteen pediatric cadaveric knee specimens (aged 3 months to 11 years) were dissected to clarify the relation of the posterior knee capsule, the meniscus, and the meniscotibial ligament complex. Metallic markers were placed marking the meniscotibial ligament capsular attachment on the proximal tibia. Specimens underwent computed tomography scanning to evaluate pin placement and relation to the physis. A digital measurement tool was used to measure the distances between the proximal tibial physis and the pins (placed at 5 points on both the lateral and medial menisci).

Results

In each specimen, clear separation was noted between the posterior joint capsule from the meniscus and meniscotibial ligament complex in the medial and lateral compartments. There was an increase in the distance between the proximal tibial physis and the insertion points of the meniscotibial ligament complex with increasing specimen age. For both the medical and lateral menisci in group 1, the median meniscotibial ligament insertion points were often less than 7 mm (interquartile range, 0.00-7.8 mm) away from the physis. The median meniscotibial ligament insertion points in group 2 tended to be farther from the physis but always less than 20 mm (interquartile range, 2.5-17.5 mm)—and as close as less than 5 mm (lateral posterior root).

Conclusions

In this anatomic study of pediatric knees, we observed a distinct recess/cul-de-sac space between the posterior knee capsule and meniscal attachments in all specimens. This defines a distinct plane between the posterior knee capsule and the meniscotibial ligament complex, with a distance between the physis and meniscotibial ligament capsular attachments that increases with age.

Clinical Relevance

The anatomic parameters evaluated in our study should be considered as future meniscal repair and transplantation techniques aim to restore the meniscal anatomy, stability, and mobility provided by the meniscotibial ligament complex and capsule structures.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
在小儿标本的膝关节后囊和半月板胫骨韧带复合体之间发现凹陷
目的 确定小儿半月板内侧和外侧的半月板韧带复合体的手术解剖结构,以及它们与胫骨近端骨骺和后关节囊的关系。方法 解剖 14 个小儿膝关节尸体标本(年龄在 3 个月到 11 岁之间),以明确膝关节后囊、半月板和半月板韧带复合体的关系。在胫骨近端半月板胫腓韧带囊附着处放置了金属标记。对标本进行计算机断层扫描,以评估针的位置和与腓骨的关系。使用数字测量工具测量胫骨近端骺板与针脚(放置在半月板外侧和内侧的 5 个点上)之间的距离。结果在每个标本中,都发现关节后囊与半月板和半月板韧带复合物之间在内侧和外侧有明显的分离。随着标本年龄的增加,胫骨近端骺端与半月板胫骨韧带复合体插入点之间的距离也在增加。对于第1组的内侧和外侧半月板,半月板韧带插入点的中位距离通常小于7毫米(四分位间范围,0.00-7.8毫米)。结论 在这项小儿膝关节解剖研究中,我们观察到所有标本的膝关节后囊和半月板附着物之间都有一个明显的凹陷/凹槽空间。这在膝关节后囊和半月板韧带复合体之间定义了一个独特的平面,髋臼和半月板韧带囊附着物之间的距离随年龄增长而增加。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
CiteScore
2.70
自引率
0.00%
发文量
218
审稿时长
45 weeks
期刊最新文献
Continuous Meniscal Repair Technique Allows for Shorter Operative Time and Learning Curve Compared With Traditional Vertical Mattress Technique in Controlled Arthroscopic Training in Porcine Model Concomitant Popliteomeniscal Fascicles Tears Are Found in 21% of Professional Soccer Players With Acute Anterior Cruciate Ligament Injuries Mini-Open Technique for Gluteus Medius Tendon Repairs Is Associated With Low Complication Rates and Sustained Improvement in Patient Reported Outcomes at 2-Year Follow-Up The Top-20 Studies About Anterior Shoulder Instability From an Altmetric Analysis Had Higher Levels of Evidence Than Those From a Traditional Bibliometric Analysis Medial Patellofemoral Ligament Augmented With a Reinforced Bioinductive Implant Is Biomechanically Similar to the Native Medial Patellofemoral Ligament at Time Zero in a Cadaveric Model
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1