Department of Anatomical Dissection and Donation, Medical University of Lodz, Poland.
Clinic of Orthopaedic and Paediatric Orthopaedics, Medical University of Lodz, Poland.
Ann Anat. 2022 Oct;244:151983. doi: 10.1016/j.aanat.2022.151983. Epub 2022 Jul 16.
The ligamentum mucosum is a ligamentous structure within the synovial layer of the knee joint capsule. It usually arises from the infrapatellar fat pad and is inserted into the intercondylar notch of the femur. In recent years, more attention has been paid to this structure because of its clinical significance. Despite the growing attention, the complex morphology of the ligamentum mucosum has led to many misunderstandings among the scientists and clinicians. Therefore, the main objective of this study was to characterize the morphology of the ligamentum mucosum and its attachment points, classify it, and evaluate its prevalence.
Classical anatomical dissection was performed on 70 lower limbs of human fetuses fixed in 10% formalin solution. Morphology was carefully assessed, and morphometric measurements were performed. The types revealed were classified.
The ligamentum mucosum was present in 100% of all 70 specimens examined. Two types were detected. Type I (65.71%) - "cord-like". This type was the most common and is characterized by a single longitudinal ligament. The proximal attachment of the ligamentum mucosum was located in the middle of the infrapatellar fat, and the distal attachment was at the tip of the intercondylar notch. Type II (34.29%) - "vertical septum". This type is less common, but its morphology is much more complex compared to type I. It is wider and thicker than type I. Proximally, it is attached to the infrapatellar fat pad and distally through the entire intercondylar notch down to the anterior surface of the anterior cruciate ligament. It divides the joint cavity into medial and lateral sides.
The ligamentum mucosum exhibits high morphologic variability, and the view that it is a vestigial remnant of the embryologic development of the knee should be reconsidered. We have proposed an anatomical classification of its types in human fetuses, which is a valuable addition to existing knowledge and will hopefully change the approach of clinicians and scientists.
黏膜韧带是膝关节滑膜层内的一种韧带结构。它通常起源于髌下脂肪垫，并插入股骨髁间切迹。近年来，由于其临床意义，人们对这种结构越来越关注。尽管越来越受到关注，但黏膜韧带复杂的形态导致科学家和临床医生对其存在许多误解。因此，本研究的主要目的是描述黏膜韧带的形态及其附着点，对其进行分类，并评估其发生率。
对 70 例福尔马林固定的人胎儿下肢进行经典解剖学解剖。仔细评估形态，并进行形态测量。揭示的类型进行分类。
在检查的所有 70 个标本中，黏膜韧带均存在于 100%的标本中。检测到两种类型。I 型（65.71%）-“索状”。这种类型最为常见，其特征是单个纵形韧带。黏膜韧带的近端附着位于髌下脂肪中间，远端附着于髁间切迹尖端。II 型（34.29%）-“垂直隔膜”。这种类型不太常见，但与 I 型相比，其形态更为复杂。它比 I 型更宽更厚。在近端，它附着于髌下脂肪垫，在远端通过整个髁间切迹向下延伸至前交叉韧带的前表面。它将关节腔分为内侧和外侧。
黏膜韧带具有高度的形态变异性，认为它是膝关节胚胎发育的遗迹的观点应该重新考虑。我们在人胎儿中提出了其类型的解剖学分类，这是对现有知识的有价值的补充，并有望改变临床医生和科学家的方法。
