A cadaveric study of the anterolateral ligament: re-introducing the lateral capsular ligament

2014 ◽  
Vol 23 (11) ◽  
pp. 3186-3195 ◽  
Author(s):  
Scott Caterine ◽  
Robert Litchfield ◽  
Marjorie Johnson ◽  
Blaine Chronik ◽  
Alan Getgood
Keyword(s):  
Anterolateral Ligament ◽  
Cadaveric Study ◽  
Capsular Ligament ◽  
Lateral Capsular Ligament

Segond tibial condyle fracture: lateral capsular ligament avulsion.

Radiology ◽  
1986 ◽  
Vol 159 (2) ◽  
pp. 467-469 ◽  
Author(s):  
G W Dietz ◽  
D M Wilcox ◽  
J B Montgomery
Keyword(s):  
Capsular Ligament ◽  
Tibial Condyle ◽  
Lateral Capsular Ligament ◽  
Condyle Fracture

scholarly journals Anatomical Consideration of the Anterolateral Ligament of the Knee

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Ho-Jung Cho ◽  
Dai-Soon Kwak
Keyword(s):  
Tibial Plateau ◽  
Anterolateral Ligament ◽  
Lateral Part ◽  
Anterior Border ◽  
Capsular Ligament ◽  
Morphological Variations ◽  
Iliotibial Tract ◽  
Prevalence Difference ◽  
Korean Adult ◽  
Length Width

Many researchers have studied the structures of the anterolateral part of the knee. Several researchers have investigated the existence of the anterolateral ligament (ALL) and its frequency has been inconsistently reported. Therefore, we assessed whether the ALL is the anatomical true ligament and studied the morphological variations of this structure. Sixty-four Korean adult cadavers (120 knees, mean age: 79.1 years) were used for this study. The lateral part of the knee joint was carefully dissected with internal rotation of the tibia. We checked the existence and morphological features and measured the dimensions (length, width, and thickness) of the ALL. The ALL was clearly distinguished from the capsulo-osseous layer of the iliotibial tract and runs obliquely from the lateral femoral epicondyle to the tibial plateau. The ALL was found in 42.5% of the samples, and 15 cadavers had ALLs in both knees. There was no prevalence difference between females and males. Most of the anterior border of the ALL was blended with the knee capsule. Therefore, we concluded that this structure is a local thickening of the capsule in the anterolateral region of the knee, where it possibly developed against some external physical stress. Therefore, the ALLs in this present study can be defined as a capsular ligament of the knee and, as per the nomenclature of the capsular ligament, can be also called the ‘anterolateral (capsular) ligament’.

scholarly journals PEDIATRIC REFERENCE ANATOMY FOR ANTEROLATERAL LIGAMENT RECONSTRUCTION– A CADAVERIC STUDY

2020 ◽  
Vol 8 (4_suppl3) ◽  
pp. 2325967120S0027
Author(s):  
Sahej D Randhawa ◽  
Sunny Trivedi ◽  
Tyler J. Stavinoha ◽  
Theodore J. Ganley ◽  
Marc Tompkins ◽  
...  
Keyword(s):  
Lateral Collateral Ligament ◽  
Anterolateral Ligament ◽  
Joint Line ◽  
Cadaveric Study ◽  
Clear Understanding ◽  
Tibial Insertion ◽  
Quantitative Anatomy ◽  
Text Figure ◽  
Anterolateral Complex ◽  
Gerdy’S Tubercle

Background: The anatomy of the anterolateral ligament (ALL) has been controversial, with modern studies varying in their description of the precise origin and insertion, as well as relation to surrounding structures on the lateral femur and anterolateral tibia Regardless of such controversy, principles of reconstruction, even non-anatomic, require a clear understanding of the referenced anatomy and surrounding structures. Due to high rates of primary and recurrent ACL tears in pediatric/adolescent patients, the use of ALL reconstruction is increasing in these groups. No pediatric cadaveric study to date has clearly identified the locations of the known surrounding structures of the anterolateral ligamentous complex. Purpose: The purpose of this study was to quantitatively assess the anatomy of the pediatric lateral collateral ligament (LCL) origin, the popliteus origin, and in the tibial insertion of the iliotibioband (ITB). Methods: Nine pediatric cadaveric knee specimens were dissected to identify the ligamentous femoral origin of the LCL, popliteus, and tibial insertion of the ITB.. Marking pins were used to localize the central footprint of these structures, followed by CT Scans. Results: LCL & Popliteus: On the femur, the popliteus was consistently found deep to the LCL and inserted both distally and anteriorly to the LCL a mean distance of 4.6 mm (range 1.9 to 7.6 mm; std dev 2.0). The LCL measured a mean of 12.5 mm to the joint line while the popliteus measured a mean of 8.2 mm from the joint line. Both the LCL and popliteus were consistently distal to the physis. The LCL was a mean distance of 4.4 mm (range 1.0 - 9.5 ) and the popliteus was a mean distance of 8.2 (range 1.7 – 12.5), respectively. ITB insertion: The ITB insertion at Gerdy’s tubercle had an average footprint measuring 28.2 mm2 (range 10.3-58.4), and the ITB center was found proximal to the physis in 6 specimens and distal in 3 specimens. Mean distance from the footprint center to the physis was 1.6 mm proximal (range 7.1 mm proximal to 2.2 mm distal). Conclusion: This study provides quantitative anatomy to structures on the lateral femur and anterolateral tibia, commonly referenced in descriptions of the ALL and lateral extraarticular reconstruction techniques. Knowledge of these structures will define the anterolateral complex and guide extra-articular procedures that provide extraarticular anterolateral rotatory stabilization in the pediatric patients. [Figure: see text][Figure: see text]

scholarly journals Anatomic Study and Reanalysis of the Nomenclature of the Anterolateral Complex of the Knee Focusing on the Distal Iliotibial Band: Identification and Description of the Condylar Strap

2019 ◽  
Vol 7 (1) ◽  
pp. 232596711881806 ◽  
Author(s):  
Philippe Landreau ◽  
Antoine Catteeuw ◽  
Fawaz Hamie ◽  
Adnan Saithna ◽  
Bertrand Sonnery-Cottet ◽  
...  
Keyword(s):  
Qualitative Evaluation ◽  
Iliotibial Band ◽  
Lateral Ligament ◽  
Macroscopic Anatomy ◽  
Anatomic Structure ◽  
Capsular Ligament ◽  
Deep Surface ◽  
Mean Width ◽  
Anterolateral Complex ◽  
Lateral Capsular Ligament

Background: The capsulo-osseous layer (COL), short lateral ligament, mid–third lateral capsular ligament, lateral capsular ligament, and anterolateral ligament (ALL) are terms that have been used interchangeably to describe what is probably the same structure. This has resulted in confusion regarding the anatomy and function of the anterolateral complex of the knee and its relation to the distal iliotibial band (ITB). Purpose: To characterize the macroscopic anatomy of the anterolateral complex of the knee, in particular the femoral condylar attachment of the distal ITB. We identified a specific and consistent anatomic structure that has not been accurately described previously; it connects the deep surface of the ITB to the condylar area and is distinct from the ALL, COL, and Kaplan fibers. Study Design: Descriptive laboratory study. Methods: Sixteen fresh-frozen human cadaveric knees were used to study the anterolateral complex of the knee. Standardized dissections were performed that included qualitative and quantitative assessments of the anatomy through both anterior (n = 5) and posterior (n = 11) approaches. Results: The femoral condylar attachment of the distal ITB was not reliably identified by anterior dissection but was in all posterior dissections. A distinct anatomic structure, hereafter termed the “condylar strap” (CS), was identified between the femur and the lateral gastrocnemius on one side and the deep surface of the ITB on the other, in all posteriorly dissected specimens. The structure had a mean thickness of 0.88 mm, and its femoral insertion was located between the distal Kaplan fibers and the epicondyle. The proximal femoral attachment of the structure had a mean width of 15.82 mm, and the width of the distal insertion of the structure on the ITB was 13.27 mm. The mean length of the structure was 26.33 mm on its distal border and 21.88 mm on its proximal border. The qualitative evaluation of behavior in internal rotation revealed that this anatomic structure became tensioned and created a tenodesis effect on the ITB. Conclusion: There is a consistent structure that attaches to the deep ITB and the femoral epicondylar area. The orientation of fibers suggests that it may have a role in anterolateral knee stability. Clinical Relevance: This new anatomic description may help surgeons to optimize technical aspects of lateral extra-articular procedures in cases of anterolateral knee laxity.

The anterolateral ligament: A cadaveric study in fetuses

2017 ◽  
Vol 30 (5) ◽  
pp. 625-634 ◽  
Author(s):  
Ainhoa Nekane Toro-Ibarguen ◽  
Juan Pretell-Mazzini ◽  
Elena Pérez ◽  
Isabel Pedrajas ◽  
Juan Miguel Cano-Egea ◽  
...  
Keyword(s):  
Anterolateral Ligament ◽  
Cadaveric Study

scholarly journals The Anterolateral Complex of the Knee

2017 ◽  
Vol 5 (10) ◽  
pp. 232596711773080 ◽  
Author(s):  
Elmar Herbst ◽  
Marcio Albers ◽  
Jeremy M. Burnham ◽  
Freddie H. Fu ◽  
Volker Musahl
Keyword(s):  
Functional Unit ◽  
Femoral Condyle ◽  
Biceps Femoris ◽  
Anterolateral Ligament ◽  
Iliotibial Band ◽  
Layer By Layer ◽  
Anatomic Structure ◽  
Capsular Ligament ◽  
Anterolateral Complex ◽  
Anterolateral Capsule

Background: Significant controversy exists regarding the anterolateral structures of the knee. Purpose: To determine the layer-by-layer anatomic structure of the anterolateral complex of the knee. Study Design: Descriptive laboratory study. Methods: Twenty fresh-frozen cadaveric knees (age range, 38-56 years) underwent a layer-by-layer dissection to systematically expose and identify the various structures of the anterolateral complex. Quantitative measurements were performed, and each layer was documented with high-resolution digital imaging. Results: The anterolateral complex of the knee consisted of different distinct layers, with the superficial and deep iliotibial band (ITB) representing layer 1. The superficial ITB had a distinct connection to the distal femoral metaphysis and femoral condyle (Kaplan fibers), and the deep layers of the ITB were identified originating at the level of the Kaplan fibers proximally. This functional unit, consisting of the superficial and deep ITB, was reinforced by the capsulo-osseous layer of the ITB, which was continuous with the fascia of the lateral gastrocnemius and biceps femoris muscles. These 3 components of the ITB became confluent distally, and the insertion spanned from the Gerdy tubercle anteriorly to the lateral tibia posteriorly on a small tubercle (lateral tibial tuberosity). Layer 3 consisted of the anterolateral capsule, in which 35% (7/20) of specimens had a discreet mid-third capsular ligament. Conclusion: The anterolateral complex consists of the superficial and deep ITB, the capsulo-osseous layer of the ITB, and the anterolateral capsule. The anterolateral complex is defined by the part of the ITB between the Kaplan fibers proximally and its tibial insertion, which forms a functional unit. A discrete anterolateral ligament was not observed; however, the anterolateral ligament described in recent studies likely refers to the capsulo-osseous layer or the mid-third capsular ligament. Clinical Relevance: The anterolateral knee structures form a complex functional unit. Surgeons should use caution when attempting to restore this intricate structure with extra-articular procedures designed to re-create a single discreet ligament.

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