An Anatomic Study of the Iliotibial Tract

Vieira, Eduardo Luís Cruells; Vieira, Eduardo Álvaro; Silva, Rogério Teixeira da; Berlfein, Paulo Augusto dos Santos; Abdalla, René Jorge; Cohen, Moisés

doi:10.1016/j.arthro.2006.11.019

Cited by 249 publications

(102 citation statements)

References 9 publications

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“…We have observed in our study that the lateral inferior geniculate artery and vein are situated between the lateral meniscal rim and the ALL (Figure 2(c)) at the level of the joint line as reported earlier [2, 10, 11]. A study by Claes et al, and an MRI study by Helito et al, discussed that the relationship of the lateral inferior geniculate vessels with ALL is an important anatomical landmark useful in identifying ALL.…”

Section: Discussionsupporting

confidence: 87%

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Morphology of Anterolateral Ligament of the Knee: A Cadaveric Observation with Clinical Insight

Potu

Salem

Abu-Hijleh

2016

Advances in Medicine

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Background. The morphology and function of anterolateral ligament (ALL) of the knee are not clearly understood even today with all the sophisticated techniques available. There have been differing descriptions of the ALL of the knee in literature, and not all of them have been named or described clearly. Aim. The present study was undertaken to provide a clear structure/relationship description on ALL. Materials and Methods. We used 24 formalin-fixed cadaveric limbs. Knee regions of the all the limbs were neatly dissected and the ALL was exposed. Its proximal and distal attachments were traced carefully. Middle portion of ALL was removed and processed for histological analysis. Results. ALL was found in one right knee (4.16%). It extended distally from the lateral femoral condyle to the lateral tibial plateau margin. Its attachment on the tibial plateau was located between head of the fibula and Gerdy's tubercle. A strong connection was identified between the ALL and the periphery of the middle third of the lateral meniscus. Histological analysis of ALL confirmed the presence of true ligamentous structure in it with dense connective tissue and plenty of fibroblasts. Conclusion. The prevalence of ALL in different populations along with its clinical significance has been discussed in detail in this paper.

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Section: Discussionsupporting

confidence: 87%

“…This might explain why classical anatomical textbooks preferred not to mention this unique structure. The name “ALL” has appeared in literature very recently by Vieira et al [10] and Vincent et al [11]. All the above-mentioned terms are now been standardized as ALL by Claes et al [2].…”

Section: Introductionmentioning

confidence: 99%

Morphology of Anterolateral Ligament of the Knee: A Cadaveric Observation with Clinical Insight

Potu

Salem

Abu-Hijleh

2016

Advances in Medicine

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“…reported on the capsulo-osseus layer of the iliotibial tract acting as an anterolateral ligament of the knee, and described its role together with the ACL as an inverted U (horseshoe) structure around the posterior aspect of the lateral femoral condyle. Aside from these main discoveries, there are a number of other authors who should also be credited for describing the ALL and for additionally postulating its importance in supporting the ACL to control rotational stability, including Irvine et al [39], Puddu et al [69], Campos et al [7], Viera et al [101], and Vincent et al [102]. …”

Section: Historymentioning

confidence: 99%

Anterolateral Ligament Expert Group consensus paper on the management of internal rotation and instability of the anterior cruciate ligament - deficient knee

et al. 2017

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Purpose of this paper is to provide an overview of the latest research on the anterolateral ligament (ALL) and present the consensus of the ALL Expert Group on the anatomy, radiographic landmarks, biomechanics, clinical and radiographic diagnosis, lesion classification, surgical technique and clinical outcomes. A consensus on controversial subjects surrounding the ALL and anterolateral knee instability has been established based on the opinion of experts, the latest publications on the subject and an exchange of experiences during the ALL Experts Meeting (November 2015, Lyon, France). The ALL is found deep to the iliotibial band. The femoral origin is just posterior and proximal to the lateral epicondyle; the tibial attachment is 21.6 mm posterior to Gerdy’s tubercle and 4–10 mm below the tibial joint line. On a lateral radiographic view the femoral origin is located in the postero-inferior quadrant and the tibial attachment is close to the centre of the proximal tibial plateau. Favourable isometry of an ALL reconstruction is seen when the femoral position is proximal and posterior to the lateral epicondyle, with the ALL being tight upon extension and lax upon flexion. The ALL can be visualised on ultrasound, or on T2-weighted coronal MRI scans with proton density fat-suppressed evaluation. The ALL injury is associated with a Segond fracture, and often occurs in conjunction with acute anterior cruciate ligament (ACL) injury. Recognition and repair of the ALL lesions should be considered to improve the control of rotational stability provided by ACL reconstruction. For high-risk patients, a combined ACL and ALL reconstruction improves rotational control and reduces the rate of re-rupture, without increased postoperative complication rates compared to ACL-only reconstruction. In conclusion this paper provides a contemporary consensus on all studied features of the ALL. The findings warrant future research in order to further test these early observations, with the ultimate goal of improving the long-term outcomes of ACL-injured patients. Level of evidence Level V—Expert opinion.

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“…After this description was made, some studies demonstrated the presence of a ligamentous structure between the lateral condyle of the femur and the anterolateral tibial region 2 11 In 2007, Vieira et al 8 introduced the term anterolateral ligament (ALL) of the knee to describe the ligament that originates in the lateral condyle of the femur anterior to the fibular collateral ligament (FCL) which has an oblique path in the anteroinferior direction with insertion in the proximal tibia between Gerdy's tubercle and the head of the fibula.…”

Section: Introductionmentioning

confidence: 99%

Study of the Anterolateral Ligament of the Knee in Formalin-Embedded Cadavers

2017

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Objective: To verify the incidence and characterize morphologically the anterolateral ligament of the knee (ALL) in cadaveric samples of the collection of the Laboratory of Anatomy of the Department of Morphology of the Universidade Federal do Espírito Santo. Methods: Dissections and cross sections were performed for mesoscopic analysis of the anterolateral region of 15 knees preserved in 4% formalin solution in order to identify the ALL. Results: After dissection of the skin and subcutaneous tissue of the knee anterolateral region, it was possible to identify the iliotibial tract (ITT), the patellar ligament and the femoral biceps tendon. The ITT was removed from the Gerdy tubercle and the following structures were visualized: knee joint capsule, fibular collateral ligament and popliteal tendon. However, the ALL was not identified in any of the samples. Conclusions: The ALL could not be identified in any of the specimens studied, either through dissection or mesoscopic analysis. Level of Evidence III, Diagnosis Studies - Investigation of an Exam for Diagnosis.

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An Anatomic Study of the Iliotibial Tract

Cited by 249 publications

References 9 publications

Morphology of Anterolateral Ligament of the Knee: A Cadaveric Observation with Clinical Insight

Morphology of Anterolateral Ligament of the Knee: A Cadaveric Observation with Clinical Insight

Anterolateral Ligament Expert Group consensus paper on the management of internal rotation and instability of the anterior cruciate ligament - deficient knee

Study of the Anterolateral Ligament of the Knee in Formalin-Embedded Cadavers

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