The anatomy of popliteomeniscal fascicles by dissections and MRI studies and their clinical significance

Abstract

Summary of resultsPMFs or popliteomeniscal fibres attach the popliteal tendon to the lateral meniscus of the knee around its posterior horn. Popliteomeniscal fascicles (PMFs) were examined in 16 human knees by MRI scans and by arthroscopy and were found to be oriented superoposteriorly ( sPMFs) and and anteroinferiorly ( iPMFs) forming 2 distinct types of PMFs. MRI found sPMFs ( iPMFs) to be of three distinct patterns – Type 1 – attached to the superior part of the lateral meniscus as a clear band, Type 2 – unclear band of fibres much as in Type 1, Type 3 ‐ no band seen. In dissections the sPMF pass from the superomedial aspect of the popliteal tendon to the posterolateral corner of the lateral meniscus while the iPMF connect the anterior edge of the popliteal tendon to the lateral edge of the lateral meniscus. Using MRI scan orientations and grossly coordinating them with dissections, sPMF form the roof of the popliteal hiatus while the iPMFs form the floor. The popliteofibular ligament is attached more distally than the PMFs to the musculotendinous junction of the popliteal tendon and posteriorly to the head of the fibular behind the attachment of the arcuate popliteal and fabellofibular ligamentsSummary of conclusionsMost cases studied were clinical and came to orthopedic OPDs with snapping or locking of the knee as complaints. Arthroscopy and MRI scans of these knees found mostly Type 2 and Type 3 PMFs. These thus are the abnormal PMFs contributing to lateral compartment knee pain, snapping knee or locking knee scenarios. The evolution of the popliteal tendon also explains the orientations of the PMFs, popliteofibular ligament, cyamella (popliteal sesamoid) and the arcuate and fabellopopliteal ligamentsGrant Funding Source: Ministry of Health