Biomechanical Assessment of the Anterolateral Ligament of the Knee

Thein, Ran; Boorman-Padgett, James; Stone, Kyle; Wickiewicz, Thomas L.; Imhauser, Carl W.; Pearle, Andrew D.

doi:10.2106/jbjs.15.00344

Cited by 122 publications

(48 citation statements)

References 28 publications

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“…These data confirm the hypothesis of Thein et al [20]. They described the ALL as the "secondary stabilizer" to the ACL.…”

Section: Discussionsupporting

confidence: 91%

See 1 more Smart Citation

Biomechanical assessment of the reconstruction of the anterolateral ligament during anterior cruciate ligament surgery

Komzák¹,

Hart²,

Paša³

et al. 2017

Clinical-Investigation

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“…These data confirm the hypothesis of Thein et al [20]. They described the ALL as the "secondary stabilizer" to the ACL.…”

Section: Discussionsupporting

confidence: 91%

“…There are cadaveric studies describing the role of this structure for the anterior-posterior and rotational stability of the knee [13,19,20]. The main role of the ALL is to prevent the Research Paper Komzák, Hart, Paša, Šmíd, Náhlík, et al After putting the patient under anesthesia, the femur was fixed using a standard metal holder.…”

Section: Introductionmentioning

confidence: 99%

Biomechanical assessment of the reconstruction of the anterolateral ligament during anterior cruciate ligament surgery

Komzák¹,

Hart²,

Paša³

et al. 2017

Clinical-Investigation

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show abstract

“…Sonnery-Cottet et al [51] and Monaco et al [34], both utilizing navigation, demonstrated increased internal rotation laxity during a dynamic pivot shift test following an ACL/ITB deficient and ACL/ALL deficient setting respectively. published their findings in a serial sectioning study showing that the ALL only engaged in load sharing beyond the physiological limits of the ACL [57]. As such they concluded that the ALL was a secondary stabilizer to anterolateral translation only after loss of the ACL, rather than a co-stabilizer.…”

Section: Biomechanics Of the Anterolateral Structuresmentioning

confidence: 97%

The anterolateral complex of the knee: results from the International ALC Consensus Group Meeting

Getgood

Brown²,

Lording

et al. 2018

Knee Surg Sports Traumatol Arthrosc

262

265

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The structure and function of the anterolateral complex (ALC) of the knee has created much controversy since the 're-discovery' of the anterolateral ligament (ALL) and its proposed role in aiding control of anterolateral rotatory laxity in the anterior cruciate ligament (ACL) injured knee. A group of surgeons and researchers prominent in the field gathered to produce consensus as to the anatomy and biomechanical properties of the ALC. The evidence for and against utilisation of ALC reconstruction was also discussed, generating a number of consensus statements by following a modified Delphi process. Key points include that the ALC consists of the superficial and deep aspects of the iliotibial tract with its Kaplan fibre attachments on the distal femur, along with the ALL, a capsular structure within the anterolateral capsule. A number of structures attach to the area of the Segond fracture including the capsule-osseous layer of the iliotibial band, the ALL and the anterior arm of the short head of biceps, and hence it is not clear which is responsible for this lesion. The ALC functions to provide anterolateral rotatory stability as a secondary stabiliser to the ACL. Whilst biomechanical studies have shown that these structures play an important role in controlling stability at the time of ACL reconstruction, the optimal surgical procedure has not yet been defined clinically. Concern remains that these procedures may cause constraint of motion, yet no clinical studies have demonstrated an increased risk of osteoarthritis development. Furthermore, clinical evidence is currently lacking to support clear indications for lateral extra-articular procedures as an augmentation to ACL reconstruction. The resulting statements and scientific rationale aim to inform readers on the most current thinking and identify areas of needed basic science and clinical research to help improve patient outcomes following ACL injury and subsequent reconstruction. Level of evidence V.

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“…Unfortunately, this experiment was performed after the ITB had been removed, and so the percentage contributions would have been over-stated, because the ITB has since been shown to be the primary restraint (see below). Thein et al [61] found that the ALL had resisted <10 N force during a tibial anterior translation test, and <17 N during the simulated pivot-shift test; thus, they concluded that the ALL could only be considered a secondary restraint.…”

Section: Anterior–posterior and Internal–external Rotation Laxity Of mentioning

confidence: 99%

Anterolateral knee biomechanics

Amis

2017

Knee Surg Sports Traumatol Arthrosc

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This article reviews the evidence for the roles of the anterolateral soft-tissue structures in rotatory stability of the knee, including their structural properties, isometry, and contributions to resisting tibial internal rotation. These data then lead to a biomechanical demonstration that the ilio-tibial band is the most important structure for the restraint of anterolateral rotatory instability. Level of evidence V.

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Biomechanical Assessment of the Anterolateral Ligament of the Knee

Abstract: Since the anterolateral ligament engages only during pathologic ranges of tibial translation, there is a limited need for anatomical reconstruction of the anterolateral ligament in a well-functioning ACL-reconstructed knee.

Cited by 122 publications

References 28 publications

Biomechanical assessment of the reconstruction of the anterolateral ligament during anterior cruciate ligament surgery

Biomechanical assessment of the reconstruction of the anterolateral ligament during anterior cruciate ligament surgery

The anterolateral complex of the knee: results from the International ALC Consensus Group Meeting

Anterolateral knee biomechanics

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