Isometric Characteristics of the Anterolateral Ligament of the Knee: A Cadaveric Navigation Study

Combined Anterior Cruciate Ligament and Anterolateral Ligament Reconstruction

“…11,12 Recent studies have concluded that there might be a biomechanical advantage to placing the graft origin posterior and proximal to the lateral epicondyle. 9 The tibial landmark is constant, midway between the Gerdy tubercle and fibular head. [4][5][6][7][8] When the graft is placed using the described landmarks, fixation should be performed in full extension.…”

“…[4][5][6][7][8] Although its function remains controversial, recent biomechanical studies have shown it is an important stabilizer against anterolateral tibial rotation and its reconstruction has shown excellent initial clinical results. [9][10][11] Several techniques have been developed to try to anatomically address this structure in the setting of an ACL reconstruction. [12][13][14] The lead author (B.S-C.) has developed a simple anatomic technique to reconstruct the ACL and the ALL of the knee using hamstring tendons and keeping the semitendinosus inserted to preserve tendon vascularization (Video 1, Table 1).…”

Minimally Invasive Anterolateral Ligament Reconstruction of the Knee

“…Relative to ALL graft placement, Imbert et al 16 recently showed no isometric behavior at any of the previously described ALL insertion points on the femur. However, they found that the femoral location proximal and posterior to the epicondyle resulted in a favorable, nonisometric pattern of lengthening in extension and loosening in flexion that promotes limitation of internal rotation at 20 of knee flexion, but increased internal rotation at 90 so as not to overconstrain the joint.…”

“…ALL graft is tight in extension to control the pivot shift and a bit lax in flexion so as not to overconstrain the knee; this is in agreement with a recent ALL cadaveric navigational study. 16,17 If not achieved, generally it relates to the femoral guide pin not positioned posterior and proximal enough relative to the lateral epicondyle, as accurate localization of the tibial attachment of the ALL is more consistent based on the initial skin measurements made here.…”

Revisión sistemática: ligamento anterolateral de la rodilla

“…Un estudio reciente realizado sobre 12 cadá-veres (47) teniendo en cuenta las 3 localizaciones femorales más frecuentes reflejadas antes en la anatomía (epicóndilo, proximal y posterior a este, y distal y anterior al epicóndilo) observó que durante la rotación interna se produce un incremento de la longitud para las 3 localizaciones femorales a 20°, pero estaban significativamente aumentadas a 90°. La mayor longitud fue observada para la inserción posterior y proximal al epicóndilo y la menor para la anterior y distal al mismo.…”