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📌 Three-Layer Approach to Medial Knee
1️⃣ Layer 1: Deep Crural Fascia
This is a superficial, thin fascial layer known as the deep crural fascia, which continues posteriorly with the sartorius fascia and fuses anteriorly with Layer 2 to form the patellar retinaculum.
2️⃣ Layer 2: Superficial Medial Collateral Ligament (sMCL)
Layer 2 comprises the superficial medial collateral ligament (sMCL) that fuses posteriorly with Layer 3, forming the posterior oblique ligament (POL) and the posteromedial capsule.
3️⃣ Layer 3: Deep Medial Collateral Ligament (dMCL), POL, and Oblique Popliteal Ligament (OPL)
Layer 3 includes the joint capsule and the deep medial collateral ligament (dMCL). Anteriorly, the anterior border of the deep MCL can be differentiated from the superficial MCL (sMCL). Posteriorly, the deep MCL bends with the sMCL.
📌 Note 1
- Patellar Retinaculum Layers: The medial patellar retinacular structures, including the MPFL, MQTFL, MPML, and MPTL, span multiple layers.
- The MPFL and MPTL are in layer 2, with adhesions to layer 1 near the patella.
- The MPML is found in layer 3, intermingled with Hoffa's fat.
- All three layers participate in the medial retinaculum.
📌 Note 2
- Pes Tendons Layers: Layer 1 comprises the deep crural fascia, continuous with the medial patellar retinaculum, covering the sartorius muscle.
- The pes anserinus tendons (sartorius, gracilis, semitendinosus) attach to the anteromedial tibia.
- Beneath layer 1, the gracilis and semitendinosus tendons are found.
- The pes tendons are situated between layers 1 and 2, with the superficial MCL in layer 2.
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#MCL, #Medialknee, #POL, #OPL, #Patellarretinaculum, #kneeanatomy, #anatomyknee
