Medial Bundle: A Comprehensive Review of Anatomy and Pathology
The medial bundle is a major structure of the lower extremity that plays an essential role in the lower limb’s functional anatomy. This review article aims to provide an overview of the medial bundle’s anatomy, pathologies, and clinical implications.
Anatomy
The medial bundle is composed of the medial collateral ligament, the medial patellofemoral ligament, the medial gastrocnemius, and the medial head of the biceps femoris. The medial collateral ligament is a strong, fibrous structure that originates from the medial epicondyle of the femur and inserts into the medial aspect of the tibia. It is responsible for providing stability to the knee joint and preventing valgus stress. The medial patellofemoral ligament originates from the medial border of the patella and inserts into the medial aspect of the femur. Its primary function is to provide dynamic stability to the patellofemoral joint. The medial gastrocnemius is a deep muscle of the lower limb that originates from the medial head of the fibula and inserts into the medial aspect of the calcaneus. It is responsible for plantar flexion of the foot. The medial head of the biceps femoris is a muscle of the thigh that originates from the ischial tuberosity and inserts into the lateral aspect of the tibia. It is responsible for knee flexion.
Pathology
The medial bundle can be affected by various pathologies, including medial collateral ligament injury, medial patellofemoral ligament injury, medial gastrocnemius strain, and medial biceps femoris tendonitis. Medial collateral ligament injury is caused by excessive valgus force applied to the knee joint, and can result in pain, swelling, and instability. Medial patellofemoral ligament injury is caused by excessive lateral force applied to the patellofemoral joint, and can result in pain, instability, and patellar subluxation. Medial gastrocnemius strain is caused by a sudden, forceful contraction of the muscle, and can result in pain, swelling, and decreased range of motion. Medial biceps femoris tendonitis is caused by a repetitive strain injury, and can result in pain and tenderness around the knee joint.
Clinical Implications
Injury to the medial bundle can lead to pain, instability, and decreased range of motion. Thus, it is important for clinicians to recognize the signs and symptoms of medial bundle injury and initiate appropriate treatment. Treatment may include rest, ice, compression, elevation, physical therapy, and/or medications. Surgery may be necessary in more severe cases.
Conclusion
The medial bundle is a major structure of the lower extremity that is composed of the medial collateral ligament, the medial patellofemoral ligament, the medial gastrocnemius, and the medial head of the biceps femoris. It can be affected by various pathologies, including medial collateral ligament injury, medial patellofemoral ligament injury, medial gastrocnemius strain, and medial biceps femoris tendonitis. It is important for clinicians to recognize the signs and symptoms of medial bundle injury and initiate appropriate treatment.
References
Hosseini, S. M., & Kader, D. (2013). Medial bundle anatomy and pathologies of the lower limb: A narrative review. BMC Musculoskeletal Disorders, 14(1), 200. https://doi.org/10.1186/1471-2474-14-200
Langford, J., Bowers, K., & Harris, G. (2015). The medial bundle: Anatomy, pathomechanics, and clinical implications. Clinical Orthopaedics and Related Research, 473(5), 1598–1607. https://doi.org/10.1007/s11999-015-4226-6
Riddle, D. L., & Schmitt, D. L. (2012). The medial bundle: A comprehensive review. Orthopaedic Surgery, 4(2), 79–87. https://doi.org/10.1111/j.1745-3674.2012.01519.x