Posteromedial capsular anatomy of the tibia for consideration of the medial meniscal support structure using a multidimensional analysis

Abstract Medial meniscal extrusion (MME) is a structural abnormality that leads to early knee osteoarthritis; however, its formation remains debated. For anatomical consideration of the mechanism underlying MME formation, we examined the capsular attachment on the posteromedial tibia and its layered...

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Main Authors: Masahiro Tsutsumi, Akimoto Nimura, Suthasinee Tharnmanularp, Shintarou Kudo, Keiichi Akita
Format: Article
Language:English
Published: Nature Portfolio 2023-07-01
Series:Scientific Reports
Online Access:https://doi.org/10.1038/s41598-023-38994-x
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author Masahiro Tsutsumi
Akimoto Nimura
Suthasinee Tharnmanularp
Shintarou Kudo
Keiichi Akita
author_facet Masahiro Tsutsumi
Akimoto Nimura
Suthasinee Tharnmanularp
Shintarou Kudo
Keiichi Akita
author_sort Masahiro Tsutsumi
collection DOAJ
description Abstract Medial meniscal extrusion (MME) is a structural abnormality that leads to early knee osteoarthritis; however, its formation remains debated. For anatomical consideration of the mechanism underlying MME formation, we examined the capsular attachment on the posteromedial tibia and its layered association with the semimembranosus. Fourteen knees of eight body donors were analyzed in this study; six knees were grouped for macroscopic analysis, whereas four knees each were grouped for histological and phosphotungstic acid-enhanced micro-computed tomography analyses. The capsular attachment varied in width according to location and was not distant from the articular cartilage and posterior root. A portion of the posteromedial joint capsule formed the semimembranosus tendinous sheath. The dense fibrous membrane superficial to the semimembranosus, which was continuous from its tendinous sheath, existed as one of the layers of the joint capsule. The aforementioned findings were confirmed in all specimens. Based on the capsular attachment and its layered association with the semimembranosus, the conventional posteromedial knee ligaments may be only a part of the joint capsule divided into two layers by the semimembranosus. If the coordinated action of the joint capsule and semimembranosus partially contributes to the medial meniscus stability, such a structural problem may affect MME formation.
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spelling doaj.art-a40fbf54eb174ef88d24bd514b1a25742023-07-30T11:14:13ZengNature PortfolioScientific Reports2045-23222023-07-0113111010.1038/s41598-023-38994-xPosteromedial capsular anatomy of the tibia for consideration of the medial meniscal support structure using a multidimensional analysisMasahiro Tsutsumi0Akimoto Nimura1Suthasinee Tharnmanularp2Shintarou Kudo3Keiichi Akita4Inclusive Medical Sciences Research Institute, Morinomiya University of Medical SciencesDepartment of Functional Joint Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental UniversityDepartment of Clinical Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental UniversityInclusive Medical Sciences Research Institute, Morinomiya University of Medical SciencesDepartment of Clinical Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental UniversityAbstract Medial meniscal extrusion (MME) is a structural abnormality that leads to early knee osteoarthritis; however, its formation remains debated. For anatomical consideration of the mechanism underlying MME formation, we examined the capsular attachment on the posteromedial tibia and its layered association with the semimembranosus. Fourteen knees of eight body donors were analyzed in this study; six knees were grouped for macroscopic analysis, whereas four knees each were grouped for histological and phosphotungstic acid-enhanced micro-computed tomography analyses. The capsular attachment varied in width according to location and was not distant from the articular cartilage and posterior root. A portion of the posteromedial joint capsule formed the semimembranosus tendinous sheath. The dense fibrous membrane superficial to the semimembranosus, which was continuous from its tendinous sheath, existed as one of the layers of the joint capsule. The aforementioned findings were confirmed in all specimens. Based on the capsular attachment and its layered association with the semimembranosus, the conventional posteromedial knee ligaments may be only a part of the joint capsule divided into two layers by the semimembranosus. If the coordinated action of the joint capsule and semimembranosus partially contributes to the medial meniscus stability, such a structural problem may affect MME formation.https://doi.org/10.1038/s41598-023-38994-x
spellingShingle Masahiro Tsutsumi
Akimoto Nimura
Suthasinee Tharnmanularp
Shintarou Kudo
Keiichi Akita
Posteromedial capsular anatomy of the tibia for consideration of the medial meniscal support structure using a multidimensional analysis
Scientific Reports
title Posteromedial capsular anatomy of the tibia for consideration of the medial meniscal support structure using a multidimensional analysis
title_full Posteromedial capsular anatomy of the tibia for consideration of the medial meniscal support structure using a multidimensional analysis
title_fullStr Posteromedial capsular anatomy of the tibia for consideration of the medial meniscal support structure using a multidimensional analysis
title_full_unstemmed Posteromedial capsular anatomy of the tibia for consideration of the medial meniscal support structure using a multidimensional analysis
title_short Posteromedial capsular anatomy of the tibia for consideration of the medial meniscal support structure using a multidimensional analysis
title_sort posteromedial capsular anatomy of the tibia for consideration of the medial meniscal support structure using a multidimensional analysis
url https://doi.org/10.1038/s41598-023-38994-x
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