Skip to main content
Log in

Occurrence and distribution of free nerve endings in the distal iliotibial tract system of the knee

  • Knee and ACL
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Free nerve endings (FNE) are nociceptive sensory elements transmitting information on pain and inflammation from the connective tissues to the brain. They form an important part of the proprioceptive sensory system of the knee. We present a qualitative and quantitative analysis of FNEs in the distal iliotibial tract (ITT), documenting their occurrence in this structure as well as their specific distribution pattern. FNEs were found in all elements of the distal ITT, with their maximum density in the fixation sites of the distal ITT to the femur and the tibia. This finding correlates well with anatomical and biomechanical studies and stresses the importance of the deep ITT fibre system for lateral knee stability. The relative number of FNEs in the distal ITT ranges from 5 to 10 per 50 mm2 and is comparable to the frequency found in the synovial sheath of the cruciate ligaments. These findings have clinical implications for surgical procedures on the lateral side of the knee. The distinct anatomy of the distal ITT should be respected in all procedures, since extensive operations in this area may cause pain and loss of range-of-motion due to alterations of proprioceptive function.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Albinus BSA (1734) Historia musculorum hominis. T. Haak and H. Mulhovius. Liedae

    Google Scholar 

  2. Barrack RL, Skinner HB, Buckley SL (1989) Proprioception in the anterior cruciate deficient knee. Am J Sports Med 17:1–6

    PubMed  Google Scholar 

  3. Biedert RM, Stauffer E, Friederich NF (1992) Occurrence of free nerve endings in the soft tissue of the knee joint. A histologic investigation. Am J Sports Med 20:430–433

    PubMed  Google Scholar 

  4. Co FH, Skinner HB, Cannon WD (1993) Effect of reconstruction of the anterior cruciate ligament on proprioception of the knee and the heel strike transient. J Orthop Res 11:696–704

    PubMed  Google Scholar 

  5. Corrigan JP, Cashman WF, Brady MP (1992) Proprioception in the cruciate deficient knee. J Bone Joint Surg [Br] 74:247–250

    Google Scholar 

  6. Douglas J (1777) Myographiae comparatae specimen or a comparative description of all the muscles in a man and in the quadruped. W. Sleater, Dublin

    Google Scholar 

  7. Freeman MAR, Wyke B (1967) The innervation of the knee joint. An anatomical and histological study in the cat. J Anat 101:505–532

    PubMed  Google Scholar 

  8. Gerlach UJ, Lierse W, Wolter D (1993) Mechanorezeptoren in den distalen Anteilen des M. vastus medialis? Unfallchirurg 96:41–42

    PubMed  Google Scholar 

  9. Halata Z (1977) The ultrastructure of the sensory nerve endings in the articular capsule of the knee joint of the domestic cat (Ruffini corpuscles and Pacinian corpuscles) J Anat 124:717–729

    PubMed  Google Scholar 

  10. Halata Z, Rettig T, Schulze W (1985) The ultrastructure of sensory nerve endings in the human knee joint capsule. Anat Embryol 172:265–275

    PubMed  Google Scholar 

  11. Hassler H, Jakob RP (1981) Em Beitrag zur Ursache der anterolateralen Instabilität des Kniegelenks. Eine Studie an 20 Leichenknien unter besonderer Berücksichtigung des Tractus iliotibialis. Arch Orthop Trauma Surg 98:45–50

    PubMed  Google Scholar 

  12. Haus J, Halata Z, Refior HJ (1992) Propriozeption im vorderen Kreuzband des menschlichen Kniegelenks—morphologische Grundlagen. Eine licht-, raster-und transmissionselektronen-mikroskopische Studies. Z Orthop 130:484–494

    PubMed  Google Scholar 

  13. Henle J (1871) Handbuch der systematischen Anatomie des Menschen. Vieweg. Braunschweig

    Google Scholar 

  14. Jakob RP, Hassler H, Stäubli H-U (1981) Observations on rotatory instability of the lateral compartment of the knee. Acta Orthop Scand [Suppl] 191:6–27

    Google Scholar 

  15. Johansson C (1992) Knee extensor performance in runners. Differences between specific athletes and implications for injury prevention. Sports Med 14:75–81

    PubMed  Google Scholar 

  16. Johansson H, Sjolander P, Sojka P (1990) Activity in receptor afferents from the anterior cruciate ligament evokes reflex effects on fusimotor neurones. Neurosci Res 8:54–59

    PubMed  Google Scholar 

  17. Johansson H, Sjolander P, Sojka P (1991) Receptors in the knee joint ligaments and their role in the biomechanics of the joint. Crit Rev Biomed Eng 18:341–368

    PubMed  Google Scholar 

  18. Johansson H, Sjolander P, Sojka P (1991) A sensory role for the cruciate ligaments. Clin Orthop 268:161–178

    PubMed  Google Scholar 

  19. Kaplan EB (1957) Facibrs responsible for the stability of the knee joint. Bull Hosp Joint Dis 17:51–59

    Google Scholar 

  20. Kaplan EB (1958) The iliotibial tract. J Bone Joint Surg [Am] 40:817–832

    Google Scholar 

  21. Kaplan EB (1962) Some aspects of functional anatomy of the human knee joint. Clin Orthop 23:18–29

    PubMed  Google Scholar 

  22. Katonis PG, Assimakopoulos AP, Agapitos MV, Exarchou EI (1991) Mechanoreceptors in the posterior ruciate ligament. Histologic study on cadaver knees. Acta Orthop Scand 62:276–278

    PubMed  Google Scholar 

  23. Krauspe R, Schmidt M, Schaible HG (1992) Sensory innervation of the anterior cruciate ligament. An electrophysiological study of the response properties of single identified mechanoreceptors in the cat. J Bone Joint Surg [Am] 74:390–397

    Google Scholar 

  24. Lobenhoffer P, Posel P, Witt S, Piehler J, Wirth CJ (1987) Distal femoral fixation of the iliotibial tract. Arch Orthop Trauma Surg 106:285–290

    PubMed  Google Scholar 

  25. Lobenhoffer P, Krettek C, Posel P, Witt S (1988) Allatomy and biomechanics of the anteroposterolateral femorotibial structures in the iliotibial band system. In: Müller W, Hackenbruch WH (eds) Surgery and arthroscopy of the knee. Springer, Berlin Heidelberg New York, pp 46–49

    Google Scholar 

  26. Lobenhoffer P, Gerich T, Lattermann C (1994) Die distale femorale Fixation des Tractus iliotibialis. Sportverletz Sportschaden 8:2–15

    PubMed  Google Scholar 

  27. Maissiat JH (1843) Etudes de physique animale. Bethune et Plon, Paris

    Google Scholar 

  28. Müller W (1982) Das Knie: Form, Funktion und ligamentäre Wiederherstellungschirurgie. Springer, Berlin Heidelberg New York

    Google Scholar 

  29. Pitman MI, Nainzadeh N, Menche D, Gasalberti R, Song EK (1992) The intraoperative evaluation of the neurosensory function of the anterior cruciate ligament in humans using somatosensory evoked potentials. Arthroscopy 8:442–447

    PubMed  Google Scholar 

  30. Sappey PC (1888) Traité d'anatomie descriptive. A. Delahaye and E. Lecrosnier Paris

    Google Scholar 

  31. Schultz RA, Miller DC, Kerr CS, Micheli L (1984) Mechanoreceptors in human cruciate ligaments. A histological study. J Bone Joint Surg [Am] 66: 1072–1076

    Google Scholar 

  32. Seebacher JR, Inglis AE, Marshall JL, Warten RF (1982) The structure of the posterolateral aspect of the knee. Bone Joint Surg [Am] 64:536–541

    Google Scholar 

  33. Sojka P, Sjölander P, Johansson H, Djupsjöbacka M (1991) Influence from stretch-sensitive receptors in the collateral ligaments of the knee joint on the gamma-muscle-spindle systems of flexor and extensor muscles. Neurosci Res 11:55–62

    PubMed  Google Scholar 

  34. Terry GC, Hughston JC, Norwood LA (1986) The anatomy of the iliotibial band and tract. Am J Sports Med 14:39–45

    PubMed  Google Scholar 

  35. Zimny ML (1988) Mechanoreceptors in articular tissue. Am J Anat 182:16–32

    PubMed  Google Scholar 

  36. Zimny ML, Schutte M, Dabezies E (1986) Mechanoreceptors in the human anterior cruciate ligament. Anat Rec 214:204–209

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lobenhoffer, P., Biedert, R., Stauffer, E. et al. Occurrence and distribution of free nerve endings in the distal iliotibial tract system of the knee. Knee Surg, Sports traumatol, Arthroscopy 4, 111–115 (1996). https://doi.org/10.1007/BF01477263

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01477263

Key words

Navigation