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Are Patellofemoral Ligaments and Retinacula Distinct Structures of the Knee Joint? An Anatomic, Histological and Magnetic Resonance Imaging Study

There is disagreement regarding the description of the patellofemoral ligaments (PFLs), considered by some authors as capsular thickening and by others as independent ligaments. It was hypothesised that the PFLs and retinacula are structures with different histological features. The aim of this stud...

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Autores principales: Biz, Carlo, Stecco, Carla, Crimì, Alberto, Pirri, Carmelo, Fosser, Michele, Fede, Caterina, Fan, Chenglei, Ruggieri, Pietro, De Caro, Raffaele
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8834464/
https://www.ncbi.nlm.nih.gov/pubmed/35162134
http://dx.doi.org/10.3390/ijerph19031110
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author Biz, Carlo
Stecco, Carla
Crimì, Alberto
Pirri, Carmelo
Fosser, Michele
Fede, Caterina
Fan, Chenglei
Ruggieri, Pietro
De Caro, Raffaele
author_facet Biz, Carlo
Stecco, Carla
Crimì, Alberto
Pirri, Carmelo
Fosser, Michele
Fede, Caterina
Fan, Chenglei
Ruggieri, Pietro
De Caro, Raffaele
author_sort Biz, Carlo
collection PubMed
description There is disagreement regarding the description of the patellofemoral ligaments (PFLs), considered by some authors as capsular thickening and by others as independent ligaments. It was hypothesised that the PFLs and retinacula are structures with different histological features. The aim of this study was to describe the stabilising structures of the patella in detail and to determine if the PFLs and retinacula are different and separable structures from a macroscopic, microscopic and imaging viewpoint. An anatomical study was performed on eight knees from five cadavers (mean age, 56.2 years; range, 35–63 years), and a histological study was conducted on specimens from nine patients having a mean age of 65 years (range 35–84 years) who had undergone surgical knee procedures. The imaging study was based on 100 MRIs (96 patients). The mean age was 46 years (range 16–88), and the study analysed the capsular-ligamentous structures. In the medial compartment, the layers and structures were as follows: superficial layer, medial retinaculum; intermediate layer, Medial Collateral Ligament (MCL), Posterior Oblique Ligament (POL) and Medial Patellofemoral Ligament (MPFL); deep layer, deep part of the MCL and joint capsule. In the lateral compartment, the layers and structures were the following: superficial layer, lateral retinaculum; intermediate layer, Lateral Collateral Ligament (LCL) and Lateral Patellofemoral Ligament (LPFL); deep layer, joint capsule. All of the knees examined presented a clearly distinguishable MPFL and LPFL separable from the capsular layer. Histological study: there was a higher density of nerve fibres in retinacula compared to ligaments (p = 0.0034) and a higher content of elastic fibres in retinacula (p < 0.0005). In imaging, there was no difference between medial and lateral retinaculum thickness (p > 0.05). In conclusion, both the lateral and medial compartment can be described using the three-layer scheme. PFLs and retinacula are separate structures both macroscopically and according to imaging analysis. The retinacula respond to their specific function with a higher nerve fibre content and higher number of elastic fibres compared to the ligaments.
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spelling pubmed-88344642022-02-12 Are Patellofemoral Ligaments and Retinacula Distinct Structures of the Knee Joint? An Anatomic, Histological and Magnetic Resonance Imaging Study Biz, Carlo Stecco, Carla Crimì, Alberto Pirri, Carmelo Fosser, Michele Fede, Caterina Fan, Chenglei Ruggieri, Pietro De Caro, Raffaele Int J Environ Res Public Health Article There is disagreement regarding the description of the patellofemoral ligaments (PFLs), considered by some authors as capsular thickening and by others as independent ligaments. It was hypothesised that the PFLs and retinacula are structures with different histological features. The aim of this study was to describe the stabilising structures of the patella in detail and to determine if the PFLs and retinacula are different and separable structures from a macroscopic, microscopic and imaging viewpoint. An anatomical study was performed on eight knees from five cadavers (mean age, 56.2 years; range, 35–63 years), and a histological study was conducted on specimens from nine patients having a mean age of 65 years (range 35–84 years) who had undergone surgical knee procedures. The imaging study was based on 100 MRIs (96 patients). The mean age was 46 years (range 16–88), and the study analysed the capsular-ligamentous structures. In the medial compartment, the layers and structures were as follows: superficial layer, medial retinaculum; intermediate layer, Medial Collateral Ligament (MCL), Posterior Oblique Ligament (POL) and Medial Patellofemoral Ligament (MPFL); deep layer, deep part of the MCL and joint capsule. In the lateral compartment, the layers and structures were the following: superficial layer, lateral retinaculum; intermediate layer, Lateral Collateral Ligament (LCL) and Lateral Patellofemoral Ligament (LPFL); deep layer, joint capsule. All of the knees examined presented a clearly distinguishable MPFL and LPFL separable from the capsular layer. Histological study: there was a higher density of nerve fibres in retinacula compared to ligaments (p = 0.0034) and a higher content of elastic fibres in retinacula (p < 0.0005). In imaging, there was no difference between medial and lateral retinaculum thickness (p > 0.05). In conclusion, both the lateral and medial compartment can be described using the three-layer scheme. PFLs and retinacula are separate structures both macroscopically and according to imaging analysis. The retinacula respond to their specific function with a higher nerve fibre content and higher number of elastic fibres compared to the ligaments. MDPI 2022-01-19 /pmc/articles/PMC8834464/ /pubmed/35162134 http://dx.doi.org/10.3390/ijerph19031110 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Biz, Carlo
Stecco, Carla
Crimì, Alberto
Pirri, Carmelo
Fosser, Michele
Fede, Caterina
Fan, Chenglei
Ruggieri, Pietro
De Caro, Raffaele
Are Patellofemoral Ligaments and Retinacula Distinct Structures of the Knee Joint? An Anatomic, Histological and Magnetic Resonance Imaging Study
title Are Patellofemoral Ligaments and Retinacula Distinct Structures of the Knee Joint? An Anatomic, Histological and Magnetic Resonance Imaging Study
title_full Are Patellofemoral Ligaments and Retinacula Distinct Structures of the Knee Joint? An Anatomic, Histological and Magnetic Resonance Imaging Study
title_fullStr Are Patellofemoral Ligaments and Retinacula Distinct Structures of the Knee Joint? An Anatomic, Histological and Magnetic Resonance Imaging Study
title_full_unstemmed Are Patellofemoral Ligaments and Retinacula Distinct Structures of the Knee Joint? An Anatomic, Histological and Magnetic Resonance Imaging Study
title_short Are Patellofemoral Ligaments and Retinacula Distinct Structures of the Knee Joint? An Anatomic, Histological and Magnetic Resonance Imaging Study
title_sort are patellofemoral ligaments and retinacula distinct structures of the knee joint? an anatomic, histological and magnetic resonance imaging study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8834464/
https://www.ncbi.nlm.nih.gov/pubmed/35162134
http://dx.doi.org/10.3390/ijerph19031110
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