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Very rare arrangement of the pes anserinus: potential clinical significance
Affiliations- Department of Anatomical Dissection and Donation, Medical University of Lodz, Poland
- Department of Anatomical Sciences, St. George’s University, Grenada, West Indies
- Department of Neurosurgery, Tulane University School of Medicine, New Orleans, Louisiana, United States
- Department of Neurology, Tulane University School of Medicine, New Orleans, Louisiana, United States
- Department of Structural and Cellular Biology, Tulane University School of Medicine, New Orleans, Louisiana, United States
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana, United States
- Department of Neurosurgery, Ochsner Medical Centre, New Orleans, Louisiana, United States
- Department of Anatomy and Embryology, School of Medicine, Complutense University of Madrid, Spain
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Abstract
The pes anserinus superficialis is composed of the semitendinosus, gracilis and sartorius tendons. Normally, they all insert to the medial side of the tibial tuberosity, and the first two are attached superiorly and medially to the tendon of the sartorius muscle. During anatomical dissection, a new pattern of arrangement of tendons creating the pes anserinus was found. The pes anserinus comprised three tendons; the semitendinosus tendon was located superiorly to the gracilis tendon, and they both had distal attachments on the medial side of the tibial tuberosity. This seemed like the normal type, but the tendon of the sartorius muscle created an additional superficial layer, its proximal part lying just below the gracilis tendon and covering the semitendinosus tendon and a small part of the gracilis tendon. After crossing the semitendinosus tendon it is attached to the crural fascia significantly below the tibial tuberosity. Good knowledge of the morphological variations of the pes anserinus superficialis is necessary during surgical procedures in the knee region, especially anterior ligament reconstruction.
Abstract
The pes anserinus superficialis is composed of the semitendinosus, gracilis and sartorius tendons. Normally, they all insert to the medial side of the tibial tuberosity, and the first two are attached superiorly and medially to the tendon of the sartorius muscle. During anatomical dissection, a new pattern of arrangement of tendons creating the pes anserinus was found. The pes anserinus comprised three tendons; the semitendinosus tendon was located superiorly to the gracilis tendon, and they both had distal attachments on the medial side of the tibial tuberosity. This seemed like the normal type, but the tendon of the sartorius muscle created an additional superficial layer, its proximal part lying just below the gracilis tendon and covering the semitendinosus tendon and a small part of the gracilis tendon. After crossing the semitendinosus tendon it is attached to the crural fascia significantly below the tibial tuberosity. Good knowledge of the morphological variations of the pes anserinus superficialis is necessary during surgical procedures in the knee region, especially anterior ligament reconstruction.
Keywords
pes anserinus, superficialis, semitendinosus, gracilis, sartorius, autograft, anterior cruciate ligament reconstruction, hamstring tendon graft, patellar tendon graft
About this articleTitle
Very rare arrangement of the pes anserinus: potential clinical significance
Journal
Issue
Vol 83, No 1 (2024): Folia Morphologica
Article type
Case report
Pages
239-243
Published online
2023-02-16
Page views
534
Article views/downloads
424
DOI
Pubmed
Bibliographic record
Folia Morphol 2024;83(1):239-243.
Keywords
pes anserinus
superficialis
semitendinosus
gracilis
sartorius
autograft
anterior cruciate ligament reconstruction
hamstring tendon graft
patellar tendon graft
Authors
Nicol Zielinska
Richard Shane Tubbs
Piotr Karauda
Teresa Vazquez
Łukasz Olewnik
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