Radiographic Landmarks for Locating the Femoral Origin and Tibial Insertion of the Knee Anterolateral Ligament

Abstract

Knowledge of the anatomic landmarks of the ALL on radiography will permit minimally invasive surgical reconstruction with lower morbidity.

Combined Intra- and Extra-articular Reconstruction of the Anterior Cruciate Ligament: The Reconstruction of the Knee Anterolateral Ligament

“…12,13 The Blumensaat line and a line perpendicular to it are used to find the origin of the ALL on an absolute lateral knee radiograph. The ALL femoral point is found at about the halfway point on the Blumensaat line in the anterior to posterior direction, around 3 to 4 mm below it.…”

“…By use of radiographic landmarks, this point is found around 7 mm below the tibial plateau on the frontal view and at around 50% of the plateau length on the lateral view. 12 The remaining portion of the gracilis then passes beneath the iliotibial tract until its tibial insertion Triple semitendinosus and single gracilis graft prepared for combined anterior cruciate ligament (ACL) and anterolateral ligament (ALL) reconstruction. The part used to reconstruct the ACL is a quadruple graft, and the remaining part of the gracilis is used to reconstruct the ALL.…”

The Fascia Lata Anterolateral Tenodesis Technique

“…5,[7][8][9][10] The point is located just proximal and posterior to the lateral femoral epicondyle, where a 2.4-mm K-wire is inserted; any possible interference with the femoral ACL tunnel should be carefully avoided. The distance between the Gerdy tubercle and the K-wire is calculated, usually corresponding to approximately 4 cm.…”

Ultrasonographic assessment of the anterolateral ligament of the knee in healthy subjects

“…A second reference anatomical identification point at the distal portion of the ALL, near to its insertion on the tibia, was the recognition of the lateral inferior branch of the geniculate artery (LIGA) 4,16 ; this small artery was identified using color-doppler or power Doppler settings. Once the distal portion of the ligament was visualized, ALL relationship with the lateral meniscal body was evaluated 4,16,18 . Then the proximal portion of the ALL was followed until its origin on the lateral femoral condyle above the popliteal fossa.…”