Applied anatomy of anterolateral ligament in adults
Liu Peidong1, Lu Zhan1, Lei Hongwei1, Wang Weiran1, Zhang Zhong2, Yang Ziquan1
1Department of Orthopaedics, the Second Hospital of Shanxi Medical University, Taiyuan 030000, China; 2Department of Anatomy, Shanxi Medical University, Taiyuan 030000, China
Abstract：Objective To explore the anatomical features of the anterolateral ligament (ALL) in Chinese population , and to provide anatomic basis for the diagnosis and treatment of anterolateral ligament injury.Methods A total of 19 adult knee joint specimens were specially selected by the Department of Anatomy of Shanxi Medical University. All the knee joint tissues from 11 males and 8 females (including 9 left knee joints and 10 right knee joints) were intact without damage, deformity and surgical trauma history. The anterior aspect of the knee joint was used as an operation center to find and observe the anatomical features of ALL, such as the starting and stopping points and traveling, etc. ALL and its adjacent structures were photographed and measured, and the research results were recorded for ualitative and quantitative description.Results In 19 cases of knee joint specimens, anterolateral ligament specimens were found in 17 cases. The lengths of ALL in the neutral 0°position and the flexion 60°with internal rotation 5°position were (34.72±6.35) mm and (39.53±6.80) mm. The widths of ALL at the femoral attachment、the tibial attachment and joint line were (7.75 ± 0.81) mm, (9.41 ± 1.19) mm and (6.79 ± 1.01) mm. The ALL as a whole was a wide flat shape from the posterior superior to the anterior lateral edge of the knee joint, with a thickness of (1.21±0.20) mm at the joint line. The tibial attachment was located above the midpoint of Gerdy's tubercle and the fibular head, and the vertical distance to the tibial cartilage margin was (11.62 ±1.32) mm. The distances from the tibial attachment to the Gerdy's tubercle and the fibular head were (19.95±4.63) mm, (19.47±3.65) mm. The distance from the Gerdy's tubercle to the fibular head was (33.82 ± 4.69) mm.Conclusions ALL is an independent non-equal length ligament structure located outside the anterior and posterior joint capsule of the knee joint. It starts from the posterior superior part of the lateral epicondyle and travels forward and downward. It connects with the lateral meniscus body and ends above the midpoint of the Gerdy's tubercle and the fibular head. ALL plays a certain role in maintaining the rotational stability of the knee joint .
刘沛东,鹿战,雷宏伟,王崴然,张忠,杨自权. 成人膝关节前外侧韧带的应用解剖学研究[J]. 中华解剖与临床杂志, 2019, 24(2): 151-156.
Liu Peidong, Lu Zhan, Lei Hongwei, Wang Weiran, Zhang Zhong, Yang Ziquan. Applied anatomy of anterolateral ligament in adults. Chinese Journal of Anatomy and Clinics, 2019, 24(2): 151-156.
Claes S, Vereecke E, Maes M, et al. Anatomy of the anterolateral ligament of the knee[J]. J Anat, 2013, 223(4): 321-328. DOI:10.1111/joa.12087.
[4]
Herbst E, Albers M, Burnham JM, et al. The anterolateral complex of the knee: a pictorial essay[J]. Knee Surg Sports Traumatol Arthrosc, 2017, 25(4): 1009-1014. DOI:10.1007/s00167-017-4449-2.
[5]
Claes S, Luyckx T, Vereecke E, et al. The Segond fracture: a bony injury of the anterolateral ligament of the knee[J]. Arthroscopy, 2014, 30(11): 1475-1482. DOI:10.1016/j.arthro.2014.05.039.
[6]
Vincent JP, Magnussen RA, Gezmez F, et al. The anterolateral ligament of the human knee: an anatomic and histologic study[J]. Knee Surg Sports Traumatol Arthrosc, 2012, 20(1): 147-152. DOI:10.1007/s00167-011-1580-3.
[7]
Dodds AL, Halewood C, Gupte CM, et al. The anterolateral ligament: anatomy, length changes and association with the Segond fracture[J]. Bone Joint J, 2014, 96-B(3): 325-331. DOI:10.1302/0301-620X.96B3.33033.
Watanabe J, Suzuki D, Mizoguchi S, et al. The anterolateral ligament in a Japanese population: study on prevalence and morphology[J]. J Orthop Sci, 2016, 21(5): 647-651. DOI:10.1016/j.jos.2016.06.004.
Daggett M, Busch K, Sonnery-Cottet B. Surgical dissection of the anterolateral ligament[J]. Arthrosc Tech, 2016, 5(1): e185-e188. DOI:10.1016/j.eats.2015.10.019.
[13]
Sonnery-Cottet B, Daggett M, Fayard JM, et al. Anterolateral ligament expert group consensus paper on the management of internal rotation and instability of the anterior cruciate ligament-deficient knee[J]. J Orthop Traumatol, 2017, 18(2): 91-106. DOI:10.1007/s10195-017-0449-8.
[14]
Helito CP, Demange MK, Bonadio MB, et al. Anatomy and histology of the knee anterolateral ligament[J]. Orthop J Sports Med, 2013, 1(7): 2325967113513546. DOI:10.1177/2325967113513546.
[15]
Caterine S, Litchfield R, Johnson M, et al. A cadaveric study of the anterolateral ligament: re-introducing the lateral capsular ligament[J]. Knee Surg Sports Traumatol Arthrosc, 2015, 23(11): 3186-3195. DOI:10.1007/s00167-014-3117-z.
[16]
Parsons EM, Gee AO, Spiekerman C, et al. The biomechanical function of the anterolateral ligament of the knee: response[J]. Am J Sports Med, 2015, 43(3): 669-674. DOI:10.1177/036354651 5597218.
[17]
Stijak L, Bumbaˇsirevic＇M, Radonjic＇V, et al. Anatomic description of the anterolateral ligament of the knee[J]. Knee Surg Sports Traumatol Arthrosc, 2016, 24(7): 2083-2088. DOI:10.1007/s00167-014-3422-6.
[18]
Jonsson H, Riklund-hlstr m K, Lind J. Positive pivot shift after ACL reconstruction predicts later osteoarthrosis: 63 patients followed 5-9 years after surgery[J]. Acta Orthopaedica Scandinavica, 2004, 75(5): 594-599. DOI:10.1080/00016470410001484.
[19]
Monaco E, Ferretti A, Labianca L, et al. Navigated knee kinematics after cutting of the ACL and its secondary restraint[J]. Knee Surg Sports Traumatol Arthrosc, 2012, 20(5): 870-877. DOI:10.1007/s00167-011-1640-8.
Tavlo M, Eljaja S, Jensen JT, et al. The role of the anterolateral ligament in ACL insufficient and reconstructed knees on rotatory stability: a biomechanical study on human cadavers[J]. Scand J Med Sci Sports, 2016, 26(8): 960-966. DOI:10.1111/sms.12524.
[23]
Lutz C, Sonnery-Cottet B, Niglis L, et al. Behavior of the anterolateral structures of the knee during internal rotation[J]. Orthopaedics & Traumatology: Surgery & Research, 2015, 101(5): 523-528. DOI:10.1016/j.otsr.2015.04.007.
2019, Vol. 24 
