The Anterolateral Ligament Does Exist

Zaffagnini, Stefano; Grassi, Alberto; Muccioli, Giulio Maria Marcheggiani; Raggi, Federico; Romagnoli, Matteo; Bondi, Alice; Calderone, Salvatore; Signorelli, Cecilia

doi:10.1016/j.csm.2017.07.002

Cited by 21 publications

(10 citation statements)

References 38 publications

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“…The results showed in all but one of the 41 dissected knees a distinct ligamentous structure, easily distinguishable from the inner joint capsule lying anterior to it, located in the antero-lateral side of the knee joint, connecting the femur with the tibia. These findings have been supported by many following anatomic studies which have reported the incidence of the ALL to be between 50% and 100% in cadaveric specimens drawn from several populations [ 9 ].…”

Section: Resultssupporting

confidence: 59%

“…In 1879 the French surgeon Paul Segond [ 8 ] described a remarkably constant avulsion fracture pattern at the antero-lateral proximal tibia as a result of forced internal rotation of the knee This eponymous Segond fracture was reported to occur in the tibial region “above and behind the tubercle of Gerdy”. Moreover, during an autopsy observation, Segond highlighted a “pearly, resistant fibrous band” located in the antero-lateral aspect of the knee, which is now advocated to be the ALL [ 9 ]. However, in both these historical works, no precise anatomical description was provided.…”

Section: Resultsmentioning

confidence: 99%

“…The 2017 consensus paper from the ALL expert group [ 31 ], defined the ALL as a distinct ligament of the antero-lateral aspect of the human knee, on the basis of its reported incidence among the cadaver studies, which resulted between the 50% and 100% [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

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The Cadaveric Studies and the Definition of the Antero-Lateral Ligament of the Knee: From the Anatomical Features to the Patient-Specific Reconstruction Surgical Techniques

Fabbro

Agostinone

Lucidi

et al. 2021

IJERPH

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Cadaver studies represented a milestone in surgical orthopaedic research, and still today they play a crucial role in the achievement of new knowledge about joint disease behaviour and treatment. In this review, an overview of the cadaver studies available in the literature about the anatomy, role, and treatment of the antero-lateral ligament (ALL) of the knee was performed. The aim of the review was to describe and gain more insight into the part of in vitro study in understanding knee joint anatomy and biomechanics, and in developing surgical reconstruction techniques. The findings of the review showed that cadaver studies had, and will continue to have, a key role in the research of knee joint biomechanics and surgical reconstruction. Moreover, they represent a powerful tool to develop and test new devices which could be useful in clinical and surgical practice.

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Section: Resultssupporting

confidence: 59%

Section: Resultsmentioning

confidence: 99%

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The Cadaveric Studies and the Definition of the Antero-Lateral Ligament of the Knee: From the Anatomical Features to the Patient-Specific Reconstruction Surgical Techniques

Fabbro

Agostinone

Lucidi

et al. 2021

IJERPH

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“…Another factor that was not taken into account is the role of the anterolateral capsule. We acknowledge that an injury of the anterolateral structures could be responsible for increased laxity, 3,37 increased tibial subluxation, and therefore and hypothetically an increased risk of failure; nevertheless, its role remains controversial 8 and not easily quantifiable, owing to suboptimal reliability of MRI 24 evaluation and the lack of pre- and postoperative objective clinical and arthrometric examination. The latter represents a further limitation, which should be investigated in future studies, since high preoperative laxity has been associated with a higher risk of primary ACL-R failure.…”

Section: Discussionmentioning

confidence: 99%

Steep Posterior Tibial Slope, Anterior Tibial Subluxation, Deep Posterior Lateral Femoral Condyle, and Meniscal Deficiency Are Common Findings in Multiple Anterior Cruciate Ligament Failures: An MRI Case-Control Study

et al. 2019

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Background: Tibiofemoral anatomic parameters, such as tibial slope, femoral condyle shape, and anterior tibial subluxation, have been suggested to increase the risk of anterior cruciate ligament (ACL) reconstruction failure. However, such features have never been assessed among patients experiencing multiple failures of ACL reconstruction. Purpose: To compare the knee anatomic features of patients experiencing a single failure of ACL reconstruction with those experiencing multiple failures or with intact ACL reconstruction. Study: Case-control study; Level of evidence, 3. Methods: Twenty-six patients who experienced failure of revision ACL reconstruction were included in the multiple-failure group. These patients were matched to a group of 25 patients with failure of primary ACL reconstruction and to a control group of 40 patients who underwent primary ACL reconstruction with no failure at a minimum follow-up of 24 months. On magnetic resonance imaging (MRI), the following parameters were evaluated: ratio between the height and depth of the lateral and medial femoral condyles, the lateral and medial tibial plateau slopes, and anterior subluxation of the lateral and medial tibial plateaus with respect to the femoral condyle. The presence of a meniscal lesion during each procedure was evaluated as well. Anatomic, demographic, and surgical characteristics were compared among the 3 groups. Results: The patients in the multiple-failure group had significantly higher values of lateral tibial plateau slope ( P < .001), medial tibial plateau slope ( P < .001), lateral tibial plateau subluxation ( P < .001), medial tibial plateau subluxation ( P < .001), and lateral femoral condyle height/depth ratio ( P = .038) as compared with the control group and the failed ACL reconstruction group. Moreover, a significant direct correlation was found between posterior tibial slope and anterior tibial subluxation for the lateral ( r = 0.325, P = .017) and medial ( r = 0.421, P < .001) compartments. An increased anterior tibial subluxation of 2 to 3 mm was present in patients with a meniscal defect at the time of the MRI as compared with patients who had an intact meniscus for both the lateral and the medial compartments. Conclusion: A steep posterior tibial slope and an increased depth of the lateral femoral condyle represent a common finding among patients who experience multiple ACL failures. Moreover, higher values of anterior subluxation were found among patients with repeated failure and those with a medial or lateral meniscal defect.

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“… 10 Although the existence, anatomy, and role of the ALL of the knee are still a matter of controversy, the importance of the anterolateral structure for rotational stability in patients undergoing ACL reconstruction has been highlighted. 12 Currently used extra-articular augmentation techniques include lateral extra-articular tenodesis or ALL reconstruction. 8 , 10 There are 2 recent debates regarding the ALL reconstruction technique.…”

Section: Discussionmentioning

confidence: 99%

Isometric Anterolateral Ligament Reconstruction Using the Semitendinosus Tendon With Suspensory Tibial Fixation

Kim

Koh

2020

Arthroscopy Techniques

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The anterolateral ligament (ALL) plays an important role in isolated anterior cruciate ligament reconstruction by providing rotational stability in a combined anterior cruciate ligament and anterolaterally injured knee. Although the ALL has been difficult to characterize anatomically, it originates near the lateral epicondyle of the distal femur and inserts into the proximal tibia between Gerdy's tubercle and the fibula head. Here, we describe an isometric ALL reconstruction using the semitendinosus tendon and an adjustable length loop suspensory tibial fixation. With this technique, it is possible to provide good stability and satisfactory results for patients with rotational instability of the knee.

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The Anterolateral Ligament Does Exist

Cited by 21 publications

References 38 publications

The Cadaveric Studies and the Definition of the Antero-Lateral Ligament of the Knee: From the Anatomical Features to the Patient-Specific Reconstruction Surgical Techniques

The Cadaveric Studies and the Definition of the Antero-Lateral Ligament of the Knee: From the Anatomical Features to the Patient-Specific Reconstruction Surgical Techniques

Steep Posterior Tibial Slope, Anterior Tibial Subluxation, Deep Posterior Lateral Femoral Condyle, and Meniscal Deficiency Are Common Findings in Multiple Anterior Cruciate Ligament Failures: An MRI Case-Control Study

Isometric Anterolateral Ligament Reconstruction Using the Semitendinosus Tendon With Suspensory Tibial Fixation

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