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Journal of Bone and Joint Surgery - British Volume, Vol 86-B, Issue 5, 674-681.
doi: 10.1302/0301-620X.86B5.14853  
Copyright © 2004 by British Editorial Society of Bone and Joint Surgery
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The posteromedial corner revisited

AN ANATOMICAL DESCRIPTION OF THE PASSIVE RESTRAINING STRUCTURES OF THE MEDIAL ASPECT OF THE HUMAN KNEE

J. R. Robinson, MRCS, Clinical Research Fellow1; J. Sanchez-Ballester, FRCS (Ed), Clinical Research Fellow1; A. M. J. Bull, PhD ARC, Lecturer in Bioengineering2; R. de W. M. Thomas, MS, FRCS, Consultant Orthopaedic Surgeon3; and A. A. Amis, DSc, Professor of Orthopaedic Biomechanics1

1 Biomechanics Section, Department of Mechanical Engineering
2 Department of Biology, Imperial College of Science, Technology and Medicine, Exhibition Road, London, SW7 2AZ, UK.
3 Department of Musculoskeletal Surgery, Imperial College London, Charing Cross Hospital, Fulham Palace Road, London, W6 8RF, UK.

Correspondence should be sent to Professor A. A. Amis.

We have reviewed the literature on the anatomy of the posteromedial peripheral ligamentous structures of the knee and found differing descriptions. Our aim was to clarify the differing descriptions with a simplified interpretation of the anatomy and its contribution to the stability of the knee.

We dissected 20 fresh-frozen cadaver knees and the anatomy was recorded using video and still digital photography. The anatomy was described by dividing the medial collateral ligament (MCL) complex into thirds, from anterior to posterior and into superficial and deep layers. The main passive restraining structures of the posteromedial aspect of the knee were found to be superficial MCL (parallel, longitudinal fibres), the deep MCL and the posteromedial capsule (PMC). In the posterior third, the superficial and deep layers blend. Although there are oblique fibres (capsular condensations) running posterodistally from femur to tibia, no discrete ligament was seen. In extension, the PMC appears to be an important functional unit in restraining tibial internal rotation and valgus.

Our aim was to clarify and possibly simplify the anatomy of the posteromedial structures. The information would serve as the basis for future biomechanical studies to investigate the contribution of the posteromedial structures to joint stability.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General