The anterolateral ligament (ALL) of the knee—Part of the iliotibial tract or a truly separate structure?

Brockmeyer, Matthias; Höfer, Denis; Schäfer, Katja; Seil, Romain; Becker, K. W.; Paulsen, Friedrich; Kohn, Dieter; Tschernig, Thomas

doi:10.1016/j.aanat.2017.02.010

Cited by 12 publications

(5 citation statements)

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“…Así mismo la búsqueda en la base de datos de artículos científicos arrojó la presencia de este epónimo en revistas del área morfológica, cuyos artículos corresponden a estudios del ligamento anterolateral de la rodilla. En los cuales, el TG se utilizó como referencia para la inserción distal de este ligamento, ubicándolo en posición posterior y proximal al TG (Zhang et al, 2018), posterior al TG (Olewnik et al, 2018), o en posición intermedia entre la cabeza de la fíbula y el TG (Claes et al, 2013;Parker & Smith, 2016;Brockmeyer et al, 2017;Toro-Ibarguen et al, 2017) En ninguno de estos artículos se describió el TG, así como no se evidenciaron términos sinónimos para él.…”

Section: Resultsunclassified

Tubérculo de Gerdy. Una Estructura Olvidada en la Terminología Anatómica Internacional

Pacheco

Lizama-Pérez

2019

Int. J. Morphol.

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RESUMEN: En la enseñanza de la anatomía, el uso de los epónimos es cada vez más escaso, sin embargo su uso aún es evidente incluso en la literatura actualizada, en este caso el uso del epónimo se acompaña generalmente del término correcto según la Terminología Anatómica Internacional (TAI). El denominado "Tubérculo de Gerdy" (TG) es un epónimo ampliamente usado en la literatura y la comunidad científica para denominar un reparo óseo ubicado en el cóndilo lateral de la tibia, corresponde a un referente anatómico y clínico importante para inserción de músculos, ligamentos y procedimientos medicoquirúrgicos de la rodilla. A pesar de esta amplia denominación, y en comparación con otros epónimos, la TAI no la incluye y no relaciona algún término oficial con esta estructura anatómica. El objetivo del trabajo fue revisar libros usados en la enseñanza de la anatomía y artículos científicos actualizados para ver la presencia y descripción de esta estructura a fin de proponer un término que se ajuste a los principios básicos

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Section: Resultsunclassified

Tubérculo de Gerdy. Una Estructura Olvidada en la Terminología Anatómica Internacional

Pacheco

Lizama-Pérez

2019

Int. J. Morphol.

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“…Ingham et al, 20 in an anatomic study of 24 animal species, were unable to find an ALL in any of the 58 specimens (including humans), but a dissection protocol was not clearly described. In contrast, Helito et al 14 demonstrated the ALL in all knees in fetal cadaveric human specimens, and Brockmeyer et al, 3 using standardized dissection protocols, identified the ALL in all adult knees. 8,10 The anterolateral knee structures are in close proximity to each other, and previous authors have noted the difficulty in dissecting embalmed specimens.…”

Section: Discussionmentioning

confidence: 96%

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

Daggett

Stephenson

Dobson

et al. 2018

Orthopaedic Journal of Sports Medicine

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Background: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).Purpose:To define and describe the distinct structures of the lateral knee and to correlate the macroscopic and histologic anatomic features.Study Design:Descriptive laboratory study.Methods: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.Results:Macroscopically, the lateral knee has 4 main layers overlying the capsule of the knee: the aponeurotic layer, the superficial layer including the iliotibial band (ITB), the deep fascial layer, and the ALL. Histologically, 8 of 12 specimens demonstrated 4 consistent, distinct structures: the ITB, the ALL, the lateral collateral ligament, and the meniscus.Conclusion:The lateral knee has a complex orientation of layers and fibers. The ALL is a distinct structure from the ITB and is synonymous to the previously described capsulo-osseous layer of the ITB.Clinical Relevance:Increasingly, lateral extra-articular procedures are performed at the time of anterior cruciate ligament reconstruction. Understanding the anatomic features of the anterolateral aspect of the knee is necessary to understand the biomechanics and function of the structures present and allows surgeons to attempt to replicate those anatomic characteristics when performing extra-articular reconstruction.

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“…However, there are also some studies that oppose this viewpoint. Brockmeyer et al 15 found that the osteofascial layer of the iliotibial tract (ITT) in the ALC also has a high attachment rate (41.1%-52.1%) in Segond fracture slices, and a large proportion of Segond fractures have ALL and ITT coattachment. When comparing the structural characteristics of the ALL and ITT of cadaveric knee joints, Rahnemai et al 16 found that the ALL was at least 4 times lower than the ITT in stiffness and ultimate load, while the ultimate elongation was 2 times higher, indicating that the ALL seemed unlikely to play an important role in providing joint stability.…”

Section: Discussionmentioning

confidence: 99%

Effects of Segond fracture and associated injuries on knee stability

Ruan

liu

et al. 2022

Preprint

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Objective: To investigate the effects of Segond fracture and associated injuries on knee stability. Methods: Retrospective analysis of 35 cases of Segond fracture, allpatients had anterior cruciate ligament rupture (100%), including 6 patients (17.1%) with avulsion fracture of tibia intercondylar eminence. There were 8 cases (22.9%) with medial collateral ligament injury. There were 5 cases (14.3%) with lateral collateral ligament injury. There were 20 cases (57.1%) with combined meniscus injury, 5cases (14.3%) with both medial and lateral meniscus injury, 3 cases (8.6%) with only medial meniscus injury, and 12cases (34.3%) with only lateral meniscus injury. All 35 patients underwent surgical treatment, including 35 cases of ligament reconstruction, 6 cases of intercondylar eminence fracture fixation, and 20 cases of meniscus repair. To compare the function and stability of knee joint before operation and 2 years after operation. Results: The Lysholm score for knee joint function on admission was (43.9±5.3) and the IKDC score was (36.1±3.9). All 35 patients were followed up for 24-36 months. X-rays showed that the Segond fractures healed 3 months after surgery. The anterior drawer test, Lachman test, McMurray test, and Lateral stress test were all negative at the last follow-up. 5 patients with lateral meniscus injury had 1 grade pivot shift at the last follow-up. The Lysholm score was (91.7±3.6), and the difference was statistically significant as compared with that before surgery (P<0.05). The IKDC score was (89.0±1.7), and the difference was statistically significant as compared with that before surgery (P<0.05). Conclusion: The indicative effect of Segond fracture on timely detection of combined injuries in the knee joint cannot be ignored. In addition to repairing the intra-articular injuries, more attention should be paid to the anterolateral structural stability of the knee joint. For Segond fracture patients with higher pivot shift grade may have residual axial migration after surgery, so ALL reconstruction surgery may be considered.

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The anterolateral ligament (ALL) of the knee—Part of the iliotibial tract or a truly separate structure?

Cited by 12 publications

References 11 publications

Tubérculo de Gerdy. Una Estructura Olvidada en la Terminología Anatómica Internacional

Tubérculo de Gerdy. Una Estructura Olvidada en la Terminología Anatómica Internacional

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

Effects of Segond fracture and associated injuries on knee stability

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