Anatomical study on the anterolateral ligament of the knee

Abstract

Objective Describe the knee anterolateral ligament (ALL) and establish its anatomical marks of origin and insertion. Methods Dissection of the anterolateral aspect of the knee was performed in six cadavers. After isolation of the ALL, its lenght, width and thickness were measured as its places of origin and insertion. The ALL origin was documented in relation to the lateral collateral ligament (LCL) origin and the insertion was documented in relation to the Gerdy tubercle, fibullar head and lateral meniscus. After the first two dissections, the ligament was removed and sent to histologycal analysis. Results The ALL was clearly identified in all knees. Its origin in the lateral epycondile was on average 0.5 mm distal and 2.5 mm anterior to the LCL. In the tibia, two insertions were observed, one in the lateral meniscus and another in the proximal tibia, about 4.5 mm distal to the articular cartilage, between the Gerdy tubercle and the fibullar head. The average measures obtained were: 35.1 mm lenght, 6.8 mm width and 2.6 mm thickness. In the ligament histological analysis, dense connective tissue was observed. Conclusion The ALL is a constant structure in the knee anterolateral region. Its origin is anterior and distal to the LCL origin. In the tibia, it has two insertions, one in the lateral meniscus and another in the proximal tibia between the Gerdy tubercle and the fibullar head.

Revisión sistemática: ligamento anterolateral de la rodilla

“…Revisión sistemática: ligamento anterolateral de la rodilla posterior al tubérculo de Gerdy (1) , en la mitad entre una línea que une la cabeza del peroné con el tubérculo de Gerdy (1,(8)(9)(10)(11)39,40) (Tabla 1 y Figura 3). La inserción femoral tenía una anchura media de 7,2-11,85 mm (1,11,14) , mientras que la tibial de 11,2-12,2 mm (1,11) .…”

“…Clásicamente, se ha considerado a la fractura de Segond un signo patognomónico de la lesión del LCA en la población adulta (68)(69)(70) . La localización de la inserción tibial del LAL posterior al tubércu-lo de Gerdy (1,(8)(9)(10)(11)39,40) y la frecuente combinación con la lesión del LCA hacen que se haya relacionado la lesión de esta estructura con la fractura de Segond (9,27,28) . La banda iliotibial (5,68,69) , la zona central de la cápsula articular (6,67) , el brazo anterior de la cabeza corta del bíceps femoral (70) y la banda anterior del LCL (5,71) también han sido propuestos como causantes de esta lesión (72) (Figura 4).…”

MRI evaluation of anterolateral ligament tears in knee injury with anterior cruciate ligament rupture

“…The ALL further follows an oblique intra-capsular course demonstrating firm attachments to the lateral meniscus (LM). The ALL inserts on to the proximal aspect of the anterolateral tibia midway between the fibular head and the Gerdy's tubercle 4,5 . Current evidence postulates that the ALL functions primarily as an essential internal rotatory stabilizer of the knee, between 30 to 90° of flexion 3 .…”

Absolute Isolated Avulsion of the Anterolateral Complex of the Knee: A Segond Fracture

“…[4][5] Recent anatomical and histological studies had described the anterolateral knee ligament (ALL). [6][7][8][9] This structure defined by Dr. Segond initially in the nineteenth century has been receiving different nomenclatures until recently be assigned as ALL. 10 Proximally, the ALL originates near the lateral femoral epicondyle and inserts distally on the lateral meniscus and the anterolateral tibial edge, halfway between Gerdy's tubercle and the fibular head.…”

“…This is the exact site of the Segond fracture according to a study by Claes et al 12 describing ACL injuries associated with this type of avulsion. [6][7][8][9][10][11] A retrospective MRI analysis of ACL injuries indicated changes in the ALL images in 78.8%. 12 The purpose of this case report is to demonstrate an isolated Segond fracture coursing with anterolateral knee instability without ACL neither other knee ligament injuries in an adult patient.…”