Conjoint Tendon (Pes Anserinus)

pes anserinus (tendo communis)

The pes anserinus (goose's foot) is the conjoined insertion of the sartorius, gracilis, and semitendinosus on the medial tibia, named for the webbed foot appearance of the three tendons fanning from their origins to a shared medial tibial insertion. The pes anserinus bursa beneath these tendons can become inflamed (pes anserinus bursitis), particularly in obese patients with knee osteoarthritis.

Region: Knee

Biomechanics

Function & Actions

Medial tibial stabilisation; combined knee flexion, tibial internal rotation, and hip flexion-abduction-external rotation

Clinical Relevance

Clinical Notes

Pes anserinus pain syndrome involves either the bursa or the tendons themselves, producing medial tibial pain approximately 5 cm below the joint line. It is reproduced by direct palpation at the tendon insertion and by resisted knee flexion with the hip abducted and externally rotated (the combined action of all three muscles). Distinguishing it from MCL injury (joint line tenderness) and medial meniscal pain is important for appropriate treatment.

Pathology

Common Injuries & Conditions

Pes Anserinus Syndrome

Bursitis or tendinopathy at the conjoined medial tibial insertion producing medial tibial pain below the joint line managed with activity modification and corticosteroid injection.