The anatomy of the anterolateral structures of the knee — A histologic and macroscopic approach

Brockmeyer, Matthias; Orth, Patrick; Höfer, Denis; Seil, Romain; Paulsen, Friedrich; Menger, Michael D.; Kohn, Dieter; Tschernig, Thomas

doi:10.1016/j.knee.2019.02.017

Cited by 22 publications

(13 citation statements)

References 48 publications

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“…Various cadaveric studies have demonstrated the presence of ALL in 50-100% of specimens [7][8][9][16][17][18][19]. In our study, ALL was present in 79% of the specimens (Figure 1, Figure 2, Figure 3).…”

Section: Discussionsupporting

confidence: 61%

“…Lateral extra-articular reinforcement procedures have been used since the 1970s as a possible solution for persistent ALRI after primary ACL reconstruction [3,6]. There has been a renewed worldwide interest in defining the anterolateral corner of the knee following the publication of the precise anatomic details of the anterolateral ligament (ALL) [7][8][9]. Cadaveric as well as clinical studies have reported on the benefits of supplementing ALL reconstruction with ACL reconstruction in cases with concomitant injuries [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

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Correlation Between the Thickness of Anterolateral Ligament and Lateral Collateral Ligament of the Knee

Chaware

Santoshi

Chaurasia

et al. 2021

Cureus

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Background Persistent anterolateral rotatory instability (ALRI) following the anterior cruciate ligament (ACL) reconstruction has led to a renewed interest in defining the role of anterolateral complex (ALC) of the knee. Methods We explored the anterolateral corner of 34 cadaveric knees to define the anterolateral ligament (ALL) in all its dimensions and measured the thickness of lateral collateral ligament (LCL) at the lateral meniscus level (tLCL) in ALL-intact and ALL-deficient knees. Results ALL was present in 27/34 (79%) of the knees. We found complete ALL in 13 cadavers bilaterally. ALL was absent bilaterally in three cadavers; it was present on one side and absent contralaterally in one cadaver. In ALL-intact knees, the average tLCL was 2.05 mm, whereas, in ALL-deficient knees, it was 2.57 mm. This difference in tLCL was statistically significant. Conclusions Our study adds new data to the recent voluminous research on ALL. We have examined the correlation between the thickness of ALL and LCL and documented alterations in the thickness of LCL in ALL-intact knees. These findings would help in designing reconstructive procedures for the combined ACL injury with ALRI.

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Section: Discussionsupporting

confidence: 61%

Section: Introductionmentioning

confidence: 99%

Correlation Between the Thickness of Anterolateral Ligament and Lateral Collateral Ligament of the Knee

Chaware

Santoshi

Chaurasia

et al. 2021

Cureus

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“…43,62 Therefore, significant focus has been placed on the anterolateral region, which includes the iliotibial band, anterolateral capsule, and anterolateral ligament. 2,5,17 ALS augmentation (ALSA) through lateral extra-articular tenodesis of the iliotibial band has shown favorable results by aiming to place a soft lateral restraint away from the central pivot of the knee. 75 Cadaveric and clinical studies have demonstrated that ALSA effectively reduced tibial internal rotation and potentially lowered the graft failure rate.…”

mentioning

confidence: 99%

Effects of Anterolateral Structure Augmentation on the In Vivo Kinematics of Anterior Cruciate Ligament–Reconstructed Knees

Chen

Wang

et al. 2021

Am J Sports Med

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Background: Double-bundle anterior cruciate ligament (ACL) reconstruction (ACLR) is a well-known treatment that restores the stability of ACL-deficient knees. However, some isolated ACL-reconstructed knees ultimately show rotatory laxity and develop osteoarthritis. Whether combined ACLR with anterolateral structure (ALS) augmentation (ALSA) can provide better improvement in the in vivo knee rotational kinematics remains unknown. Hypothesis: When compared with isolated double-bundle ACLR, combined double-bundle ACLR with ALSA can improve knee in vivo rotational kinematics and provide better restoration of knee kinematics. Study Design: Controlled laboratory study. Methods: Sixteen patients with unilateral ACL injury were randomly divided into 2 groups to receive either combined double-bundle ACLR and ALSA (ALSA group) or isolated double-bundle ACLR (ACLR group). All patients performed a single-leg lunge using the operative and nonoperative/contralateral legs under dual-fluoroscopic imaging system surveillance during a hospital visit at a minimum 1 year (12-13 months) of follow-up to assess the 6 degrees of freedom knee kinematics. Functional evaluation using the Lysholm and Marx rating scales and clinical examinations were also performed. Results: From full extension to approximately 90° of knee flexion at 5° intervals, the mean ± SD internal rotation of the reconstructed knees in the ALSA group (1.5°± 0.9°) was significantly smaller than that of the contralateral knees (8.2°± 1.9°; P = .008). The ALSA group knees also showed significantly ( P = .045) more medial translation than the contralateral knees. In the ACLR group, the mean internal rotation of the reconstructed knee (6.0°± 2.1°) was significantly smaller than that of the contralateral knees (8.9°± 0.6°; P < .001). At full extension, the tibia was significantly more externally rotated than that of the contralateral legs (0.5°± 7.4° vs 7.6°± 3.4°, P = .049). Conclusion: When compared with isolated double-bundle ACLR, double-bundle ACLR augmented with ALS reconstruction resulted in anterolateral rotatory overconstraint during the lunge motion. Clinical Relevance: Additional ALSA of double-bundle ACL-reconstructed knees overconstrained rotatory stability. Therefore, the use of ALSA for ACL-reconstructed knees should be considered with caution for patients with ACL deficiency and anterolateral rotatory instability. Longer-term follow-up to evaluate long-term outcomes and altered kinematics over time is recommended.

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“…The PLT differed histologically from the additional band of the plantaris muscle. Many other such structures have been re-evaluated in recent years 1,11,17,18 . For example, studies suggest that the anterolateral ligament of the knee, rather than being a simple thickening of the joint capsule, could be an independent anatomical structure that occurs in several variants 1 .…”

Section: Discussionmentioning

confidence: 99%

Impact of plantaris ligamentous tendon

Olewnik

Karauda

Gonera

et al. 2021

Sci Rep

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There are countless morphological variations among the muscles, tendons, ligaments, arteries, veins and nerves of the human body, many of which remain undescribed. Anatomical structures are also subject to evolution, many disappearing and others continually emerging. The main goal of this pilot study was to describe a previously undetected anatomical structure, the plantaris ligamentous tendon, and to determine its frequency and histology. Twenty-two lower limbs from 11 adult cadavers (11 left, and 11 right) fixed in 10% formalin were examined. The mean age of the cadavers at death was 60.1 years (range 38–85). The group comprised six women and five men from a Central European population. All anatomical dissections of the leg and foot area accorded with the pre-established protocol. Among the 22 lower limbs, the PLT was present in 16 (72.7%) and absent in six (27.3%). It originated as a strong fan-shaped ligamentous tendon from the superior part of the plantaris muscle, the posterior surface of the femur and the lateral aspect of the knee joint capsule. It inserted to the ilio-tibial band. Histologically, a tendon and ligament were observed extending parallel to each other. A new anatomical structure has been found, for which the name plantaris ligamentous tendon is proposed. It occurs around the popliteal region between the plantaris muscle, the posterior surface of the femur, and the ilio-tibial band.

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The anatomy of the anterolateral structures of the knee — A histologic and macroscopic approach

Cited by 22 publications

References 48 publications

Correlation Between the Thickness of Anterolateral Ligament and Lateral Collateral Ligament of the Knee

Correlation Between the Thickness of Anterolateral Ligament and Lateral Collateral Ligament of the Knee

Effects of Anterolateral Structure Augmentation on the In Vivo Kinematics of Anterior Cruciate Ligament–Reconstructed Knees

Impact of plantaris ligamentous tendon

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