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Anatomical Landmarks of the Knee

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Robert LaPrade
Robert LaPrade

Defining surgical relevant anatomic landmarks can be particularly difficult at the time of surgery. The following slides provide an outline of definable landmarks based upon our studies that have proven to be very useful to residents, fellows, and surgeons in surgery. The slides outline the primary anatomic landmarks for MCL surgery, posterolateral (PLC) knee surgery and PCL reconstructions. As many of our colleagues have done, these slides can also be printed and laminated and taped to the walls in one’s surgery center to serve as landmarks for a safe and efficient surgery.

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Bony Attachments (LaPrade, JBJS, 2007) Medial Epicondyle (ME) Adductor Tubercle (AT) Gastrocnemius Tubercle (GT) Courtesy of Dr. LaPrade
sMCL + POL Bony Attachments (LaPrade, JBJS, 2007) sMCL (femur) 3.2 mm proximal + 4.8 mm posterior to ME sMCL (proximal tibia) 12 mm distal to joint space sMCL distal tibia 60 mm distal to joint space POL (femur) 7.7 mm distal + 6.4 mm posterior to AT or 1.4 mm distal + 2.9 mm anterior to GT POL (tibia) Central arm on the semimembranosus Courtesy of Dr. LaPrade
PLC bony attachment Fibular Collateral Ligament FCL = 1o Varus stabilizer Femoral attachment: 1.4 mm Proximal + 3.1 mm posterior to lateral epicondyle Fibula insertion: Anterior lateral on the fibula head (8.2 mm post to the ant margin of the fibular head 28.4 mm distal to the tip of the fibular styloid) Popliteus Tendon PLT = 1o rotational stabilizer Femoral attachment: Average 18.5 mm anterior of the FCL attachment at 70 degree flexion Tibial attachment: Posterior on the tibia Courtesy of Dr. LaPrade
PCL Landmarks ALB: Between trochlear point and medial arch point PCL: Locate at bundle ridge PMB: Centered 8-9 mm posterior to edge of MFC articular cartilage On wall anterior edge 5.8 mm from cartilage 2-4 mm bone-bridge between ALB & PMB12.1 mm Courtesy of Dr. LaPrade Courtesy of Dr. LaPrade
Meniscus Root Posterior Lateral Root: Approx. 9 mmm posterior to MTE Approx. 8 mm anterior-lateral to PCL Posterior Medial Root: Approx. 4 mm lateral to LTE Approx. 10 mm anterior to PCL Courtesy of Dr. LaPrade

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Anatomical Landmarks of the Knee

  • 1. Bony Attachments (LaPrade, JBJS, 2007) Medial Epicondyle (ME) Adductor Tubercle (AT) Gastrocnemius Tubercle (GT) Courtesy of Dr. LaPrade
  • 2. sMCL + POL Bony Attachments (LaPrade, JBJS, 2007) sMCL (femur) 3.2 mm proximal + 4.8 mm posterior to ME sMCL (proximal tibia) 12 mm distal to joint space sMCL distal tibia 60 mm distal to joint space POL (femur) 7.7 mm distal + 6.4 mm posterior to AT or 1.4 mm distal + 2.9 mm anterior to GT POL (tibia) Central arm on the semimembranosus Courtesy of Dr. LaPrade
  • 3. PLC bony attachment Fibular Collateral Ligament FCL = 1o Varus stabilizer Femoral attachment: 1.4 mm Proximal + 3.1 mm posterior to lateral epicondyle Fibula insertion: Anterior lateral on the fibula head (8.2 mm post to the ant margin of the fibular head 28.4 mm distal to the tip of the fibular styloid) Popliteus Tendon PLT = 1o rotational stabilizer Femoral attachment: Average 18.5 mm anterior of the FCL attachment at 70 degree flexion Tibial attachment: Posterior on the tibia Courtesy of Dr. LaPrade
  • 4. PCL Landmarks ALB: Between trochlear point and medial arch point PCL: Locate at bundle ridge PMB: Centered 8-9 mm posterior to edge of MFC articular cartilage On wall anterior edge 5.8 mm from cartilage 2-4 mm bone-bridge between ALB & PMB12.1 mm Courtesy of Dr. LaPrade Courtesy of Dr. LaPrade
  • 5. Meniscus Root Posterior Lateral Root: Approx. 9 mmm posterior to MTE Approx. 8 mm anterior-lateral to PCL Posterior Medial Root: Approx. 4 mm lateral to LTE Approx. 10 mm anterior to PCL Courtesy of Dr. LaPrade