Radiographic identification of the primary posterolateral knee structures

Area of Science:

• Orthopedic surgery
• Radiology
• Anatomy

Background:

• Identifying posterolateral knee structures (fibular collateral ligament, popliteus tendon, popliteofibular ligament) is challenging in chronic injuries and revision surgeries.
• Accurate identification of these attachment sites is crucial for intraoperative guidance and postoperative assessment of reconstructions.

Purpose of the Study:

• To identify reproducible qualitative and quantitative radiographic landmarks for posterolateral knee structures.
• To enhance intraoperative and postoperative identification of these attachment sites for surgeons of all experience levels.

Main Methods:

• Descriptive laboratory study involving dissection of 11 cadaveric knee specimens.
• Radiopaque markers were used to identify attachment sites, with measurements taken on anteroposterior and lateral radiographs.
• Intraobserver and interobserver reliability assessed using intraclass correlation coefficients.

Main Results:

• High intraobserver (0.981) and interobserver (0.983) reliability was achieved.
• Specific distances from defined landmarks on anteroposterior and lateral views were quantified for the fibular collateral ligament, popliteus tendon, and lateral gastrocnemius tendon.
• The fibular collateral ligament and popliteus tendon locations were precisely defined relative to posterior femoral cortex and Blumensaat's line reference points.

Conclusions:

• Established comprehensive qualitative and quantitative radiographic guidelines for posterolateral knee structures.
• These radiographic landmarks serve as a valuable reference for surgical planning and assessment in knee reconstructions.