Anatomy of the knee

The anterolateral ligament(ALL)

• Author : Radu Branea• Co-author : Feier Andrei, Al Hussein Hussam, Tăbăcar

Mircea• Scientific coordonator : dr. Adrian Ivănescu

History

• 1879-Paul Segond: “pearly, resistant, fibrous band”[1]

(mid-third) lateral capsular ligament

Capsulo-osseous layer of the iliotibial band

Anterolateral ligament

Anatomy• The anterolateral ligament (ALL) is located on

the lateral region of the knee, anterior to the lateral collateral ligament (LCL) and posterior to Gerdy’s tubercle.

• Origin: lateral epicondyle[1] or condyle[2] of the femur• Insertion: anterolateral aspect of the proximal tibia, with 2 attachements

Background

• common procedure of orthopedics surgery : ACL reconstruction

• even after reconstruction,some patients experience tough anterolateral rotatory movement (pivot shifting)[1],[3]

• role of ALL : seems to stabilize medial rotation of the knee[1],[3]

Objective

• to provide an anatomical description of the anterolateral ligament of the knee (ALL) and describe its clinical correlations

Material and method

• Eight paired cadaveric knees belonging to the Anatomy Department

• One amputated lower limb from the Pathology Department

• dissected in the anterolateral region;

• The ALL was clearly observable

What we foundITB=Iliotibial Band

GT=Gerdy’s Tubercle

LFE=Lateral Femoral Epicondyle

LCL=Lateral Collateral Ligament

FH=Fibular Head

Results

• Origin: Lateral Femoral Epicondyle(LFE)

• Insertion: 1.proximal tibia, between Gerdy’s tubercle(GT) and fibular head(FH); 2. Lateral meniscus

• Closely related to the LCL, however independent

Results

Measurements

Length(mm) 38

Width(mm) 7

Thickness(mm) 3

Conclusions

• Formerly known as only a fascia, the ALL could now prove to be a lot more than that

• Possible involvement in ACL(Anterior Cruciate Ligament) related sports injuries

Discussions

• Pros: - new subject - emphasize the existence of the ALL

- starting point for detailed orthopaedic studies

• Cons: - ethics - small number of dissections

Bibliography• [1] Claes, S.; Vereecke, E.; Maes, M.; Victor, J.; Verdonk, P.; Bellemans, J.

(Oct 2013). "Anatomy of the anterolateral ligament of the knee.". J Anat 223 (4): 321–8

• [2] Vincent, J. P.; Magnussen, R. A.; Gezmez, F.; et al. (January 2012). "The anterolateral ligament of the human knee: An anatomic and histologic study". Knee Surg Sports Traumatol Arthrosc 20 (1): 147–52.

• [3] Helito, C. P., de Souza, H. M., Batista, M., et al. “Anatomical study on the anterolateral ligament of the knee”, Revista Brasileira de Ortopedia, 2013; 48: 368–373

• [4] Helito, C. P., Demange, M. K., Batista, M, et al.,” Anatomy and Histology of the Knee Anterolateral Ligament”, 2013, 1

Thank you!