A descriptive and morphometric study of the fabellofibular, arcuate popliteal and popliteofibular ligaments

Abstract

Objectives: The anatomical relationship of the fibrous structures in the posterolateral corner of the knee is highly complex, with many different descriptions of these structures in the literature. Discrepancy in the definitions of FF, AL and PF are a problem for both clinicians and anatomists. This study aimed to examine these structures and describe their features to clarify our understanding of their morphology. Methods: The posterolateral corner of the knee joint was bilaterally dissected in 10 male cadavers. Fibrous structures originating from the fibular head as a common mass were defined in relation to their attachment sites and positions according to the inferior lateral genicular vessels. The fabellofibular ligament (FF) was grouped into two categories, depending on the presence of a dense, fibrous tissue band. The arcuate popliteal ligament components were grouped into superficial (ALs) and deep (ALd) by their position relative to the inferior lateral genicular vessels. The popliteofibular ligament (PF) was identified as the fibrous bundle attached to the inferior border of popliteus tendon (PT). Dimensions of these structures were measured, and statistical analyses undertaken using paired and independent t-tests (p<0.05 significant). Results: FF had a dense fibrous band in 11 out of 20 knees. The fabella thickness was significantly higher in cases which FF had a dense fibrous band (p=0.04). ALs and PF were present in all knees. Absence of ALd was observed in 5 out of 20 knees.  Conclusion: Findings indicate the structural relationship between ALs and FF, variability in the morphology of the ligaments and a positive relationship between fabella thickness and FF morphology. Some structures were consistently present (AL, PF), while ALd was only present intermittently. We suggest descriptions of the posterolateral ligaments of knee that utilize attachment sites, relationships with the inferior lateral genicular vessels, and developmental relationships to the popliteus muscle to clarify terminology for these structures.

Keywords

• arcuate popliteal ligament
• fabellofibular ligament
• popliteofibular ligament
• posterolateral corner reconstruction

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