Abstract

The goal of this article is to have a comprehensive review of the anatomy of the pes anserinus (PA) and the spectrum of pathologic conditions that can affect this structure. After the insertion site of the PA tendons was fully exposed, careful dissection was performed to determine the exact shape of the PA. Insertions were made into the gracilis and superficial layers of the sartorius and the deep layers of the semitendinosus on the medial side of the tibia. Sixty-six percent of specimens had one semitendinosus tendon at the insertion site, while 31 percent had two, and 3 percent had three. A connection was made between the deep fascia of the leg and the tendons of the gracilis and semitendinosus. The anserine bursa was a somewhat asymmetrical, roughly circular shape. Some of the anserine bursa specimens even extended beyond the proximal line of the tibia. The anserine bursa, as seen from the medial side of the tibia, was situated posteriorly & superiorly from the tibial midline, paralleling the sartorius muscle. Anserine bursa injections should be given at an angle of 20 degrees medially and inferiorly from the vertical line, 15 or 20 millimetres deep, and roughly 20 millimetres medially and 12 millimetres superior from the inferomedial point of the tibial tuberosity.