Interactive Transcript
0:00
Knee anatomy, lateral collateral ligament or
0:03
LCL complex, including the LCL or FCL, fibular collateral ligament.
0:10
This comes from our Total Body Atlas
0:12
in MRI where we see some important locking zones or insertion points.
0:18
They're actually origins for structures
0:20
like the popliteus, which is depicted here in yellow. The gastrocnemius, which is
0:26
slightly posterior and maybe a little bit inferior to the one we're interested
0:30
in right now, the fibular collateral ligament.
0:34
So the fibular collateral ligament,
0:36
often called the lateral collateral ligament is rounded.
0:39
It's more narrow and less broad than its counterpart, the so-called medial
0:44
collateral ligament, also known in some circles as the tibial collateral ligament,
0:49
which is considered the middle layer or the superficial aspect of the deep MCL.
0:57
The fibular collateral ligament stretches obliquely downward and backward
1:02
from the lateral epicondyle of the femur, above to the head of the fibula below.
1:07
But don't be misled, that insertion
1:10
on the fibula, along with several other structures, is quite complex.
1:15
In contrast to the MCL,
1:17
it's fused with neither the capsular ligament nor the lateral meniscus.
1:22
Now, I'm not talking about the LCL complex.
1:24
I'm just talking about the lateral
1:27
collateral ligament, formerly known as the artist fibular collateral ligament.
1:32
The lateral collateral ligament is more
1:35
flexible than its medial counterpart, so it's less susceptible to injury.
1:39
So when it is injured, it's usually
1:42
a pretty serious and potentially catastrophic injury.
1:45
It's about 14mm anterior and slightly
1:48
distal to the gastrocnemius origin, although there's some variability
1:53
regarding the height related to one versus the other.
1:56
But it always arises above and posterior to the popliteus tendon.
2:02
It has an attachment to the tibia, little known.
2:07
The attachment to the tibia, we'll see, is involved in severe various
2:11
injuries and may lead to the segond fracture or the lateral capsular sign.
2:17
LCL tears are associated with injury of other posterolateral and corner
2:22
structures to be detailed in a corner section.
2:25
Now, the popliteus muscle and its myotendinous unit, sit outside of the joint.
2:32
The popliteus origin sits inside the joint.
2:37
Intra-articular tears, involving the hiatus of the popliteus, and/or popliteal femoral
2:43
attachment, are intra-articular injuries and they are less common than strains or
2:50
injuries of the popliteus muscle and myotendinous unit.
2:54
The LCL and the biceps femoris, can't talk about one without the other
2:59
at the insertion because they attach right next to each other along the lateral
3:03
margin of the fibular head, not the fibular styloid.
3:07
This accounts for the reduced likelihood
3:09
of an avulsion injury compared to injuries of the popliteofibular ligament,
3:15
the fabellofibular ligament and the arcuate ligaments, all of which may
3:19
be associated with avulsions of the fibular styloids.
3:23
So this may help you on conventional radiography.
3:26
So now let's have a look at our head
3:28
of the fibula, which is a little more daunting than you might have thought.
3:33
Here is our fibular collateral or lateral collateral ligament in yellow.
3:38
We've also got a biceps femoris
3:40
which we're going to detail, in greater detail, when we talk about the biceps
3:45
femoris, but there are two components to it.
3:48
The main component sits behind the FCL and they don't actually anatomically join
3:55
but they are called on their insertion point, the conjoint tendon.
3:59
There's another component of the biceps femoris that runs a little more anterior
4:05
and slightly medial to the FCL and that will be a story for its own vignette.
4:10
Now, the styloid process tip provides
4:13
attachment for the arcuate ligament, which is seen here in blue.
4:17
We said light blue but it's kind of like
4:19
navy blue, anterior to the fabellofibular ligament, which you're going to see has
4:25
an inverse relationship with regard to its size compared with components
4:29
of the arcuate. Big arcuate, small fabellofibular ligament and vice versa.
4:35
The popliteofibular ligament, which is a very important stabilizing
4:40
structure, that's oft-overlooked, is attached medial to these two and we see
4:46
it here articulated and demonstrated in pink.
4:50
Now, let's look at some MR in the axial projection.
© 2024 Medality. All Rights Reserved.