Evaluation of the anterolateral ligament of the knee by means of magnetic resonance examination

Abstract

ObjectiveTo evaluate the presence of the anterolateral ligament (ALL) of the knee in magnetic resonance imaging (MRI) examinations.MethodsThirty-three MRI examinations on patients’ knees that were done because of indications unrelated to ligament instability or trauma were evaluated. T1-weighted images in the sagittal plane and T2-weighted images with fat saturation in the axial, sagittal and coronal planes were obtained. The images were evaluated by two radiologists with experience of musculoskeletal pathological conditions. In assessing ligament visibility, we divided the analysis into three portions of the ligament: from its origin in the femur to its point of bifurcation; from the bifurcation to the meniscal insertion; and from the bifurcation to the tibial insertion. The capacity to view the ligament in each of its portions and overall was taken to be a dichotomous categorical variable (yes or no).ResultsThe ALL was viewed with signal characteristics similar to those of the other ligament structures of the knee, with T2 hyposignal with fat saturation. The main plane in which the ligament was viewed was the coronal plane. Some portion of the ligament was viewed clearly in 27 knees (81.8%). The meniscal portion was evident in 25 knees (75.7%), the femoral portion in 23 (69.6%) and the tibial portion in 13 (39.3%). The three portions were viewed together in 11 knees (33.3%).ConclusionThe anterolateral ligament of the knee is best viewed in sequences in the coronal plane. The ligament was completely characterized in 33.3% of the cases. The meniscal portion was the part most easily identified and the tibial portion was the part least encountered.

Ultrasonographic visualization and assessment of the anterolateral ligament

“…On dissection, an anterolateral structure was identified in eight of ten knees-within the reported range of ALL prevalence [4,5,8,15,19]. The structure did not appear to be contiguous with the meniscofemoral ligament in any samples.…”

Assessment of the Anterolateral Ligament of the Knee by Magnetic Resonance Imaging in Acute Injuries of the Anterior Cruciate Ligament

“…The small ALL thickness and its anatomical variability also difficult the complete visualization. 5,11,12 Helito et al 5 performed a study in 39 patients and identified the ALL in its entirety in around two-thirds of the MRI scans, but additional coronal proton densityeweighted sequences without fat saturation were also used. Taneja et al, 13 in a study of 70 patients, were able to visualize the ALL in its entirety in a very low percentage of the MRI scans, observing some portion of the ligament in around half of the scans.…”

Surgical Treatment for Avulsion Fractures of the Anterolateral Ligament Associated with Periarticular Fractures of the Knee

“…Coquart et al [11] reported completely visible in 82% and partially visible in 11.5%. Helito et al [18] reported completely visible in 33.3% and partially visible in 48.5%. A recent study reported that the percentage agreement between MRI and surgical ndings was 88% for ALL injury.…”