Anatomical study of paratenons and fascia lata connections in the posteromedial knee region

Abstract

Introduction: In the last decade, fascia research increased significantly in various aspects such as anatomical and biomechanical features related to epimuscular force transmission.

Methods: The present anatomic study focuses on macroscopic observations of the potential gracilis and semitendinosus paratenons, as well as fascial surroundings connections in the posteromedial knee region on 17 lower-limbs dissections.

Results: The gracilis and semitendinosus expansions and paratenons were observed in all specimen and further connections with the fascia lata and crural fascia were demonstrated. Contrary to the previously described expansions connected to the tendons, we observed that the expansions were the edges of the paratenon tunnel and that the paratenon structure surrounded the overall muscle. Both paratenons of gracilis and semitendinosus were connected to the crural fascia and, respectively, to the sartorius fascia (part of the fascia lata), to the semimembranosus and the fascia lata. Furthermore, numerous connections between the fascia lata and the neighboring structures in the posteromedial knee region are described.

Discussion-conclusion: The present study describes for the first time gracilis and semitendinosus paratenons and other surrounding fascial connections. Such macroscopic observations may represent a new basis for further characterization of the myofascial pathway of epimuscular force transmission in the knee region.

Keywords: Crural fascia; Deep fascia; Epimuscular force transmission; Fascia lata; Gracilis muscle; Paratenon; Semitendinosus muscle.