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Medial Collateral Ligament

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Description

Relationship of the MPFL (medial patellofemoral ligament), VMO (vastus medialis obliquus muscle), SM (semimembranosus), MGT (medial gastrocnemius tendon), POL (posterior oblique ligament) and sMCL (superficial medial collateral ligament).[1]

General

  • Forms part of the capsuloligamentous complex of the medial knee
  • 8 to 10 cm ligament in length, is the largest structure found on the medial aspect of the knee

Superficial MCL (sMCL)

  • Also known as the tibial collateral ligament
  • Origin: proximally from the posterior aspect of the medial femoral epicondyle
  • Insertion: medial condyle of the tibia 5–7 cm below the joint line near the level Pes Anserinus
    • First part: inserts anterior to semimembranosus tendon, 12 mm distal to joint line
    • Second part: more distal, 61 mm distal to the joint line, inserts anterior to posteromedial crest of tibia
  • Function: Primary static stabilizer to valgus stress of the knee
    • Proximal portion: stabilizes against valgus forces in all degrees of knee flexion
    • Distal portion: stabilizes stabilizes in external rotation at 30-60° of knee flexion and in internal rotation[2]

Deep portion of the MCL (dMCL)

  • Also known as the mid-third capsular ligament, represents thickening of the medial joint capsule
  • Meniscofemoral (ligaments of Humphrey and Wrisberg)
    • Inserts into the medial meniscus, immediately distal to insertion of sMCL
  • Meniscotibial (coronary ligament) ligament
    • Originates from the medial meniscus
    • Attaches to the medial tibial plateau
  • Function: major secondary restraint to anterior translation of the tibia, provides minor static stabilization against valgus stress
    • Also helps control against internal and external rotation

Posterior Oblique Ligament

  • Controversy whether this is a portion of the Semimenbranosus, part of superficial MCL, or a distinct structure
  • Resides on the posterior aspect of the superficial portion of the MCL
  • Provides additional static and dynamic stabilization for the medial aspect of the knee

MCL Bursa (Voshell's Bursa)

  • Found between the superficial and deep portions of the medial collateral ligament
  • Anterior margin: adjacent to the anterior border of the superficial portion of the MCL
  • Posterior margin: outlined by the junction of the superficial, deep portions
  • Tibial component and femoral component (70% of cases)[3]

Actions

  • Primary static stabilizer to valgus stress of the knee

Vascular Supply


Innervation


Clinical Significance


See Also


References


  1. Memarzadeh, Arman, and Joel TK Melton. "Medial collateral ligament of the knee: Anatomy, management and surgical techniques for reconstruction." Orthopaedics and Trauma 33.2 (2019): 91-99.
  2. Encinas-Ullán, Carlos A., and E. Carlos Rodríguez-Merchán. "Isolated medial collateral ligament tears: an update on management." EFORT open reviews 3.7 (2018): 398.
  3. De Maeseneer M, Shahabpour M, Van Roy F, Goossens A, De Ridder F, Clarijs J, Osteaux M. MR imaging of the medial collateral ligament bursa: findings in patients and anatomic data derived from cadavers. (2001) AJR. American journal of roentgenology. 177 (4): 911-7.
Created by:
John Kiel on 29 November 2020 18:15:47
Authors:
Last edited:
12 March 2023 22:08:58
Category: