J Knee Surg 2019; 32(07): 637-641
DOI: 10.1055/s-0038-1666867
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Pellegrini–Stieda Lesion of the Knee: An Anatomical and Radiological Review

M. P. Somford
1  Department of Orthopaedic Surgery, Rijnstate Hospital, Arnhem, The Netherlands
,
R. P. A. Janssen
2  Department of Orthopaedic Surgery, Máxima Medisch Centrum, Eindhoven, The Netherlands
,
D. Meijer
3  Department of Orthopaedic Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
,
T. A. P. Roeling
4  Division of Surgical Specialties, Department of Anatomy, University Medical Centre, Utrecht University, Utrecht, The Netherlands
,
C. Brown Jr
5  International Knee and Sports Medicine Centre, Abu Dhabi, United Arab Emirates
,
D. Eygendaal
3  Department of Orthopaedic Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
6  Department of Orthopaedic Surgery, Amphia Hospital, Breda, The Netherlands
› Author Affiliations
Further Information

Publication History

12 December 2017

26 May 2018

Publication Date:
10 July 2018 (online)

Abstract

The Pellegrini–Stieda lesion is a calcification on the medial side of the knee. The origin of this tissue is controversial. The purpose of our study is to investigate the origin of the Pellegrini–Stieda lesion using conventional radiography as to recreate the circumstances in which Pellegrini and Stieda had to study this pathology. Six nonpaired fresh-frozen cadaveric knees were used. A surgical approach to the medial side of the knee was performed using the layered approach. The origin of the gastrocnemius muscle (GM) (n = 3) or the superficial medial collateral ligament (sMCL) (n = 3) were marked with a radio-opaque fluid. X-ray analysis was performed by measuring the distance from the proximal part of the marking to the medial tibial plateau, multilayer views, and comparison to the original X-rays by Pellegrini–Stieda. Two out of three markings in both the GM and sMCL group were matched with the correct structure. The images were digitally processed so that the osseous structures became partly transparent. After overlaying the images, we found a random distribution of the markings. The Stieda/GM group had no overlap of the markings at all. Compared with the original images from the publications by Pellegrini and Stieda, no comparable position could be found between the original lesions and the markings in our specimens. Conventional X-ray of the knee could not reproduce a distinction between the sMCL and GM as origins for the Pellegrini–Stieda lesion as suggested by Pellegrini and Stieda.