154 
On the Sesamoids of the Knee-Joimt 
we have already cited in this direction Cheselden and Sommering (see our pp. 150 
and 151). Quain, however, in 1867 {Elements of Anatomy, 7th edition, London, 
Vol. I, p. 284) can tell us nothing more than : 
A sesamoid fibro-cartilage is sometimes met with over the outer condyle and occasionally over 
the inner, it is rarely ossified — 
a statement which is apparently incorrect in at least two points ; — while Gray 
as late as 1905 {Anatomy, Descriptive and Surgical) is content with the assertion 
that there is a sesamoid fibro-cartilage (rarely) osseus in the tendon of the outer 
head and one occasionally in the tendon of the inner head— another statement too 
brief to be in any way accurate. 
The German anatomists have been somewhat more precise. Hyrtl in 1838 
(" Physiologische anatomische Bemerkungen tiber die Kniegelenksknorpel," Medi- 
cinisches Jahrhuch d. K. K. Oesterr. States. Bd. xx, Wien, S. 31 — 32) tells us that 
the fahella. lateralis is more frequent than the fahella mesialis, that they may be 
hemisesamoids, and that he has found them in both heads of M. gastrocnemius. 
Again in his Lelirhuch der Anatotiiie der Menschen, 12 Aufl., Wien, 1873, S. 420, 
after stating that Camper had only seen fahellae in the external head, he continues : 
" Nach meinen Beobachtungen kommt es in beiden Kopfen vor, obwohl in ausseren 
ungleich hiiufiger." Lastly we may note that Gegenbauer in 1890 {Lelirhuch der 
Anatomie der Menschen, Leipzig, S. 457) has for a text-book a fairly complete and 
adequate statement. 
Before we come to the important memoirs of the last quarter of the 19th 
century which have made the sesamoids a special study we ought to note an 
important memoir by Macalister of 1872 {Muscular Anomalies in Human Anatomy, 
Dublin, 1872*). It is important for our purposes for three reasons : 
(a) Because it provides evidence for the existence of the vaesisX fahella in man: 
Gastrocnemius — 1. May have a sesamoid bone in its inner head : I have found it : 2. Or in 
its outer — this is more common, (p. 118.) 
Macalister clearly speaks here of an orthosesamoid, not a hemisesamoid. 
(6) Because it gives the first statement of the existence of the cyamella lateralis 
as an anomaly in man. 
(c) Because it records anomalies of the popliteus muscle which have consider- 
able bearing on both the fahella lateralis and the cyamella lateralis. 
Popliteus muscle has been described as double (Fabricus ab Aquapendente : " De Motu locali 
Auimalium " in Opera Anatomica et Physiologica, Lipsiae, 1687, p. 359). The same has been seen 
by Professor Bevan, of the Royal College of Surgeons, Ireland A small superior popliteus, arising 
from the outer condyle, and above the popliteus muscle, to which it was united, and inserted into 
the upper part of the tibia, was seen by Calorit. A sesamoid bone has been fovmd in its tendon. 
Slips from the semi-membi-anosus have been found inserted into the fascia over this muscle. 
* Also as Transactions Itoyal Irish Academy, Vol. xxv, 1872. J. F. Knott, "Muscular Anomalies," 
Proc. R. Irish Academy, Second Series, Vol. iii, p. 639, 1882, notes a case of bilateral orthosesamoid in 
tendon of Popliteus. 
t Mem. della Accad. delle Scienze delV Istituto di Bologna, 2 series. Vol. vi, p. 143, refers only to 
the supernumerary popliteal muscle not to sesamoids. 
