The Medial Cross And The Anteromedial Region Of The Knee Revisited, A Cadaveric Study
Jorge PB, Oliveira DE, Malpaga JMD, Canuto SMG, Helito CP, Horita MMObjectives
The medial knee structures have a primary role in valgus and rotational stress stabilizing, making them important in the global assessment of the ligament-injured knee and choosing the most adequate treatment This study aimed to conduct a layer-by-layer dissection of the knee anteromedial side and to describe, qualitatively and quantitatively, the anatomy and histology of the Anterior Oblique Ligament (AOL) and its relationship with what the authors call The Medial Cross, an important ligament complex that stabilizes the Medial Pivot
Methods
35 fresh-frozen knees resulting from transfemoral amputations, which were exclusively performed for vascular reasons, were dissected. Structures were identified after meticulous dissection, respecting the same protocol, measured with a digital caliper rule (Mitutoyo TM)., and histologically studied for data.
Results
The Medial Cross is represented by the superficial Medial Collateral Ligament, the AOL (anterior region), and the Posterior Oblique Ligament (POL). The Anterior Oblique Ligament was found in all dissected knees. It the mean length was 31,47 ± 5.06 mm. This structure presented ligament histology with densely organized collagen fibrils.
Conclusion
The 35 dissections reported in this study demonstrate a ligamentous structure, called AOL, in the knee medial region. It originates from the anterior border of the medial epicondyle and inserts more widely, under the articular surface, thus having a fan shape. It is in an extracapsular situation, not directly related to the medial meniscus, and represent the Medial Cross anterior arm. Studying and revisiting the medial compartment can provide important information for understanding joint instability, and promoting better results in ligament reconstructions.