Anatomical study on the anterolateral ligament of the knee (original) (raw)

The anterolateral ligament of the human knee: an anatomic and histologic study

Knee Surgery, Sports …, 2012

Purpose The functional anatomy of the knee is frequently studied but remains incompletely understood. Numerous authors have described a structure in the lateral knee connecting the lateral femoral condyle with the lateral meniscus and tibial plateau. The goal of this study is to define the incidence, anatomy, and histology of this structure, the anterolateral ligament. Methods The incidence of the ligament was determined in 30 consecutive patients undergoing total knee arthroplasty (TKA) for medial compartment osteoarthritis. The anatomy and histology were evaluated using 10 cadaveric knees. Results The anterolateral ligament was noted to be present in all 40 knees. In all cases, it was noted to take origin near or on the popliteus tendon insertion and insert into the lateral meniscus and tibial plateau 5 mm distal to the articular surface and posterior to Gerdy's Tubercle. The average width of the relatively flat structure was 8.2 ± 1.5 mm, and the average length was 34.1 ± 3.4 mm. Histologic analysis revealed a discreet structure with a fibrous core surrounded by synovium. Fibers blended with the popliteus at its origin and with the lateral meniscus as it passed distally. Conclusions The anterolateral ligament may play a role in preventing anterior tibial translation. The role, if any, of this structure in meniscal stability and the pathology of meniscal tears remain unclear.

Morphology of Anterolateral Ligament of the Knee: A Cadaveric Observation with Clinical Insight

Advances in Medicine, 2016

Background. The morphology and function of anterolateral ligament (ALL) of the knee are not clearly understood even today with all the sophisticated techniques available. There have been differing descriptions of the ALL of the knee in literature, and not all of them have been named or described clearly.Aim. The present study was undertaken to provide a clear structure/relationship description on ALL.Materials and Methods. We used 24 formalin-fixed cadaveric limbs. Knee regions of the all the limbs were neatly dissected and the ALL was exposed. Its proximal and distal attachments were traced carefully. Middle portion of ALL was removed and processed for histological analysis.Results. ALL was found in one right knee (4.16%). It extended distally from the lateral femoral condyle to the lateral tibial plateau margin. Its attachment on the tibial plateau was located between head of the fibula and Gerdy’s tubercle. A strong connection was identified between the ALL and the periphery of t...

Anatomy and Histology of the Knee Anterolateral Ligament

Orthopaedic Journal of Sports Medicine, 2013

Background: Reconstruction of the anterior cruciate ligament (ACL) is one of the most common procedures in orthopaedic surgery. However, even with advances in surgical techniques and implants, some patients still have residual anterolateral rotatory laxity after reconstruction. A thorough study of the anatomy of the anterolateral region of the knee is needed.

The anterolateral ligament of the knee: A dissection study

Knee, 2016

Background: Recent studies have described the presence of the anterolateral ligament (ALL). However, there is still no consensus regarding the anatomy of this structure with the topic controversially discussed. The aim of this study was to provide an anatomical description of the ligamentous structures on the anterolateral side of the knee with special emphasis on the ALL. Methods: Forty-four human cadaveric knees were dissected to reveal the ALL and other significant structures in the anterolateral compartment of the knee joint. The ALL was defined as a firm structure running in an oblique direction from the lateral femoral epicondyle to a bony insertion at the anterolateral tibia. Results: The ALL was identified in 45.5% (n = 20) of the dissected knee joints. The structure originates together with the fibular collateral ligament (45%) or just posterior and proximal to it (55%). The ligament has an extracapsular, anteroinferior, oblique course to the anterolateral tibia with a bony insertion between Gerdy's tubercle and the fibular head. The ALL had its greatest extend at 60°of knee flexion and maximal internal rotation. Conclusion: The ALL is a firm ligamentous structure in the anterolateral part of the knee present in 45.5% of the cases. Given the course and characteristics of this structure, a function in providing rotational stability by preventing internal rotation of the knee is likely. Clinical relevance: The ALL might be an important stabilizer in the knee and may play a significant role in preventing excessive internal tibial rotation and subluxation of the knee joint.

Anatomical, Histological and Biomechanics Analysis of the Anterolateral Ligament

International Journal of Health Science, 2023

The present work focuses on carrying out a bibliographical research on the anterolateral ligament of the knee, with the main objective of incorporating the results obtained from the articles analyzed, in relation to anatomy, histology and ligament biomechanics. The literature search was through the MEDLINE database via PubMed® and SciElo®, focusing on articles that contained the objectives proposed by the research. The anterolateral ligament does not have a constant incidence, due to the different forms of dissection used by studies, it is worth highlighting that the distal to proximal method was more successful in identifying the ligament. Therefore, studies seek to understand the anatomy of the anterolateral ligament, which is covered by fibrous connective tissue and originates from the lateral epicondyle of the femur, varying proximally, distally, anteriorly and posteriorly in relation to the lateral collateral ligament. It has an anterodistal trajectory towards the tibia, where it is inserted between the head of the fibula and Gerdy's tubercle, and in the meniscus between the anterior horn and the body of the meniscus. Regarding biomechanics, studies converge on the explanation that the ligament has the function of stabilizing the knee.

The Structure and Function of the Anterolateral Ligament of the Knee: A Systematic Review

Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2015

Purpose: The purpose of this systematic review was to evaluate the anatomic structure and function of the anterolateral ligament (ALL) of the knee. Methods: The Medline, Embase, and Cochrane databases were screened for all studies related to the ALL of the knee. Two reviewers independently reviewed all eligible articles and the references of these articles. Inclusion and exclusion criteria were applied to all searched studies. Quality assessment was completed for the included studies. Results: Nineteen studies were identified for final analysis. Pooled analysis identified the ALL in 430 of 449 knees (96%) examined. The ligament was found to originate from the region of the lateral femoral epicondyle and insert on the proximal tibia midway between the Gerdy tubercle and the fibular head. The ALL was found to be 34.1 to 41.5 mm in length, 5.1 to 8.3 mm in width above the lateral meniscus, and 8.9 to 11.2 mm in width below the lateral meniscus. By use of magnetic resonance imaging, the ALL was identified in 93% of knees examined (clinical, 64 of 70; cadaveric, 16 of 16). In one case study the ligament was clearly visualized by ultrasound examination. Histologic analysis across 3 studies showed characteristics consistent with ligamentous tissue. Though not shown in biomechanical studies, it is hypothesized that the ALL provides anterolateral stability to the knee, preventing anterolateral subluxation of the proximal tibia on the femur. One study identified a network of peripheral nerves, suggesting a proprioceptive function of the ALL. Conclusions: This systematic review shows the ALL to be a distinct structure with a consistent origin and insertion sites. The ALL is an extra-articular structure with a clear course from the lateral femoral epicondyle region, running anteroinferiorly, to the proximal tibia at a site midway between the Gerdy tubercle and the head of the fibula. The function of this ligament is theorized to provide anterolateral knee stability. Level of Evidence: Level IV, systematic review of cadaveric and imaging studies.

Cadaveric Study on the Anterolateral Ligament of Knee: A Clinical Perspective Research Article

SciDoc Publishers, 2020

Background: The original discovery of an extra-articular ligamentous structure on the anterolateral aspect of the knee, now called the "Anterolateral ligament (ALL)" is credited to Dr Paul Segond. The ALL plays a key role in maintaining the rotational stability of tibia, hencea deeper comprehension of morphology of the ALL is necessary. Objective:To study the qualitative and quantitative characteristics of the ALL. Materials and methods: The study was conducted on 44 embalmed human cadaveric knees (34 male and 10 female), mean age 78.1 years.The various dimensions of the ALL (length, width, thickness) were measured using Verniercaliper, and its relations with surrounding structures were noted. Results: The mean length of the ALL in extension was 34.91±5.39mm and 39.15±5.46mm at 900 flexion, indicating stretching of the ligament during mid-flexion. The mean width of the ALL at femoral origin measured 8.33±2.74mm, at joint line 9.50±3.06mm and distal flaring at tibial insertion was clearly visible with mean width of 10.45±2.63mm. The ALL thickness at the joint line after separating it from lateral meniscus was 5.37±0.91mm. The lateral tibial recess was 7.32±1.72mm. The average distance between the centre of tibial ALL insertion to Gerdy's tubercle was 19.33±3.35mm and to the tip of the fibular head was 21.03 ± 5.78mm. There were no significant sex differences in any of the comparison. Conclusion: This study clarifies the long-standing enigma surrounding the existence of a ligamentous structure, connecting femur with the anterolateral aspect of proximal tibia.

ANATOMICAL, HISTOLOGICAL AND BIOMECHANICS ANALYSIS OF THE ANTEROLATERAL LIGAMENT (Atena Editora)

ANATOMICAL, HISTOLOGICAL AND BIOMECHANICS ANALYSIS OF THE ANTEROLATERAL LIGAMENT (Atena Editora), 2023

Anatomic and Histological Study of the Anterolateral Aspect of the Knee: A SANTI Group Investigation

Orthopaedic journal of sports medicine, 2018

The structure and function of the anterolateral aspect of the knee have been significantly debated, with renewed interest in this topic since the description of the anterolateral ligament (ALL). To define and describe the distinct structures of the lateral knee and to correlate the macroscopic and histologic anatomic features. Descriptive laboratory study. Twelve fresh-frozen human cadavers were used for anatomic analysis. In the left knee, a layer-by-layer dissection and macroscopic analysis were performed. In the right knee, an en bloc specimen was obtained encompassing an area from the Gerdy tubercle to the posterior fibular head and extending proximally from the anterior aspect to the posterior aspect of the lateral femoral epicondyle. The en bloc resection was then frozen, sliced at the level of the joint line, and reviewed by a musculoskeletal pathologist. Macroscopically, the lateral knee has 4 main layers overlying the capsule of the knee: the aponeurotic layer, the superfic...

Radiographic Landmarks for Identifying the Anterolateral Ligament of the Knee

Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association, 2016

To identify the radiographic position of the origin and insertion of the anterolateral ligament (ALL) of the knee on a lateral radiograph. Twelve unpaired, fresh-frozen cadaveric knees were dissected to expose the ALL. The origin and insertion of the ALL on each cadaver were then tagged using 2-mm radiopaque beads. True lateral fluoroscopic views of the knee were then obtained, and the distance from known radiographic landmarks was recorded by 2 reviewers. The origin of the ALL was found at a distance that is 37.0 ± 9.2% of the total anterior-posterior length of the femoral condyle from the posterior edge as measured along Blumensaat's line. The insertion was located at a distance that is 56.1 ± 6.9% of the total length of the tibial plateau from the posterior edge. The origin of the ALL is 5 mm posterior to a line from the posterior femoral cortex and 9 mm distal to a line along Blumensaat's line. The insertion is 4 mm anterior to the 50% mark of the anterior-posterior widt...

Anatomical study on the anterolateral ligament of the knee (original) (raw)

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