Anatomic variations of the pes anserinus: a cadaver study.

Abstract

Both knees of 51 cadavers were dissected to identify anatomic variations of the pes anserinus. The tendons of the sartorius, gracilis, and semitendinosus were exposed through an inverted L subperiosteal incision beginning at the crest of the tibia. The upper border of the gracilis tendon was located an average of 5.5 cm from the anteromedial joint line. The tendons of the gracilis and semitendinosus fuse an average of 3.18 cm from their insertion and are firmly adherent to layer I (sartorius tendon). Forty-eight percent of the specimens demonstrated at least one of seven variations, ranging from fascial loops connecting the sartorius tendon with the medial collateral ligament to separate tendon slips from each of the three tendons inserting separately into the tibia or the crural fascia. This exposure is recommended to safely and efficiently dissect the tendons of the pes anserinus for use in reconstructive procedures of the knee.