Anat Cell Biol.  2014 Jun;47(2):127-131. 10.5115/acb.2014.47.2.127.

Pes anserinus and anserine bursa: anatomical study

• Lee JH
• Kim KJ
• Jeong YG
• Lee NS
• Han SY
• Lee CG
• Kim KY
• Han SH

• KMID: 1882583
• DOI: http://doi.org/10.5115/acb.2014.47.2.127

Abstract

This study investigated the boundary of anserine bursa with the recommended injection site and shape on the insertion area of pes anserinus (PA), with the aim of improving clinical practice. Eighty six legs from 45 Korean cadavers were investigated. The mixed gelatin solution was injected to identify the shape of anserine bursa, and then the insertion site of the PA tendons was exposed completely and carefully dissected to identify the shape of the PA. The sartorius was inserted into the superficial layer and gracilis, and the semitendinosus was inserted into the deep layer on the medial surface of the tibia. The number of the semitendinosus tendons at the insertion site varied: 1 in 66% of specimens, 2 in 31%, and 3 in 3%. The gracilis and semitendinosus tendons were connected to the deep fascia of leg. Overall, the shape of the anserine bursa was irregularly circular. Most of the anserine bursa specimens reached the proximal line of the tibia, and some of the specimens reached above the proximal line of the tibia. In the medial view of the tibia, the anserine bursa was located posteriorly and superiorly from the tibia's midline, and it followed the lines of the sartorius muscle. The injection site for anserine bursa should be carried out at 20degrees from the vertical line medially and inferiorly, 15 or 20 mm deeply, and at the point of about 20 mm medial and 12 mm superior from inferomedial point of tibial tuberosity.

Keyword

Cadaver; Anserine bursa; Pes anserinus; Bursa injection

MeSH Terms

Anserine*
Cadaver
Fascia
Gelatin
Leg
Tendons
Tibia
Anserine
Gelatin

Figure

• 

  Fig. 1 Sartorius tendon variation at the insertion site. Some parts of the sartorius tendon were inserted into deeper layer than the gracilis and semitendinosus tendons (arrow). ANT, anterior, G, gracilis; S, Sartorius; ST, semitendinosus; SUP, superior.

• 

  Fig. 2 Typical insertion site of the pes anserinus. Dotted line denotes the inferior border of the sartorius muscle. (A) Semitendinosus was attached to the inner space of the inferior borders of sartorius. (B) Semitendinosus was attached inferior to the Sartorius. ANT, anterior; G, gracilis; S, Sartorius; ST, semitendinosus; SUP, superior.

• 

  Fig. 3 Variation of the semitendinosus tendon at the insertion site. (A) The semitendinosus tendon was divided into two. (B) The semitendinosus tendon was divided into three. ANT, anterior; G, gracilis; POST, posterior; S, Sartorius; ST, semitendinosus; SUP, superior.

• 

  Fig. 4 The injection method in the anserine bursa. The injection-needle was positioned at 20° from the vertical line medially and inferiorly, 20.0±2.0 mm medial and 12.0±3.0 mm superior from the inferomedial point of the tibial tuberosity. SUP, superior; MED, medial.

• 

  Fig. 5 The anserine bursa revealed by injection of gelatin containing blue ink. IB, infrapatellar branch; S, Sartorius; SN, saphenous nerve; SV, saphenous vein; ANT, anterior; SUP, superior.

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  Fig. 6 The distribution of nerves and vessels in the anserine bursa. The proximal line of AB from inferomedial point of tibial tuberosity (IMPTT) was 16.0±5.0 mm, the distal line of AB from IMPTT was 65.0±7.0 mm, the posterior line of AB from IMPTT was 60.0±7.6 mm. ANT, anterior; SUP, superior.

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