Surgery

Biography

Biography: Ashaolu, James Olumide

Abstract

The knee is the most complex joint in the human body. It is constituted by bones such as the femur, tibia, fibula and patella which are held together as a component by ligaments while the  knee movement is created by the surrounding muscles. There is paucity of information regarding the morphological variation of knee ligaments and muscles in African subjects while surgical and radiological assessments have relied on informations derieved from caucasian specimens and it was usually expected that the world human population has almost similar anatomical arrangement. The knowlegde of  ligamentous and muscular variations around the knee in Africans is important in clinical diagnosis and surgical interventions, not only to African surgeons but also to the international surgical community, considering how medical tourism has created global patient flow. The anterolateral ligament was lately reported as a dominant structure often omitted and of high biomechanical and clinical importance. However, studies on African subjects have provided contrasting information as regards anterolateral ligament high dominance  and another prevalent ligament newly named the triradiate collateral ligament was discovered which possessed three arms and would inform  unique surgical approach. Again, It was observed that the lateral collateral ligament may not always be present. Studies on the medial aspect of knee in African subjects have re-classified the pes anserinus due to its extensive variability from the regular knowlegde. Pes anserinus in African subjects inserted differently from the regular pattern and the tendinous constitution was  also uncommon. Examination of the muscles of the posterior aspect of the knee in African subjects has also shown that the gastrocnemius muscle four-headed  pattern is dominant as against the two-headed pattern in other populations previously reported. Studies are underway to examine the cruciate ligaments  and  include wider African subjects. Magnetic resonance and ultrasographic imaging of the newly discovered ligaments and muscles are being investigated to aid clinical identification. Moreover, the unique structural patterns of the musculo-ligamentous entities of the knee in Africans suggest different development and ecomorphological adaptation, and therefore require a complementary surgical approach.