Research on the Anterolateral Ligament of the Knee: An Evaluation of PubMed Articles From 2010 to 2019

Santoso, Asep; Anwar, Iwan Budiwan; Sibarani, Tangkas; Soetjahjo, Bintang; Utomo, Dwikora Novembri; Mustamsir, Edi; Budhiparama, Nicolaas C.

doi:10.1177/2325967120973645

Cited by 6 publications

(9 citation statements)

References 30 publications

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“…Despite several publications on the subject in the past decade worldwide and several publications by Brazilian authors on the subject 19 in this series of cases, we found only one report (0.97%) containing information on ALL. Thus, we understand that it would be appropriate to increase the active search for ALL during the evaluation of images by radiologists in orthopedics, enabling other data for the surgeon to define if the associated reconstruction between the ACL and ALL in the acute phase will be made and facilitate the authorization of the procedures and materials necessary by healthcare insurers.…”

Section: Discussioncontrasting

confidence: 56%

Evaluation of the Anterolateral Ligament of the Knee in Magnetic Resonance Mri: Case Series

et al. 2023

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Objective: To evaluate the citation of the ligament in the magnetic resonance imaging (MRI) reports and confirm its presence and injury in the images of exams performed in the acute phase retrospectively. Methods: In total, 103 patients who underwent anterior cruciate ligament (ACL) reconstruction in 2019 were included. The images were reanalyzed by two radiologists. Results: In the first analysis, only one report mentioned the anterolateral ligament (ALL) and its injury (0.97%). On reanalysis, ALL was visualized in almost all cases (95% and 97%). An injury was found in 53 (51.5%) cases by radiologist A and in 56 (54.4%) cases by radiologist B. The injury was diagnosed by both in 39 (37.9%) cases (p < 0.0001). Radiologists disagreed regarding the injury (Kappa = 0.411). Conclusion: The reports failed to describe the ligament and diagnose a significant number of injuries. The analysis of conventional resonance images still presents divergences in the diagnosis of ALL injury associated with the ACL among radiologists. Level of Evidence IV, Case Series.

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Section: Discussioncontrasting

confidence: 56%

Evaluation of the Anterolateral Ligament of the Knee in Magnetic Resonance Mri: Case Series

et al. 2023

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“…The anterolateral ligament (ALL), an anterolateral capsular structure located deep in the iliotibial band, was recently found to contribute to the rotational stability of the knee joint [5, 20, 25, 28, 30]. Accordingly, interest in this structure has increased, and numerous investigations have been conducted [31]. Although still controversial, anterolateral augmentation procedures (ALL reconstruction or lateral extra‐articular tenodesis) in conjunction with anterior cruciate ligament (ACL) reconstruction have been reported to control rotational stability effectively and to reduce graft failure rates [1, 9, 11, 12, 19, 27, 37, 38].…”

Section: Introductionmentioning

confidence: 99%

“…Third, no investigations on the possible influence of geometric factors that may affect tunnel collisions were conducted. Given the increasing incidence of anterolateral augmentation procedures [24, 31, 40], a well‐designed study that overcomes the potential limitations of these previous studies is required.…”

Section: Introductionmentioning

confidence: 99%

The orientation of the ALL femoral tunnel to minimize collision with the ACL tunnel depends on the need or not of far-cortex drilling

Moon

Choi

Seo

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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Purpose To (1) evaluate the optimal drill orientation of the anterolateral ligament (ALL) femoral tunnel to minimize collision with the anterior cruciate ligament (ACL) femoral tunnel during anatomical ACL reconstruction according to the need for far-cortex drilling and (2) investigate the geometric factors that afect tunnel collision secondary to drill orientation of the ALL femoral tunnel. Methods A three-dimensional femoral model of patients who underwent anatomical single-bundle ACL reconstruction between 2015 and 2016 was constructed, and the geometric factors were evaluated. Virtual ALL femoral tunnels were created to simulate 45 drilling conditions. For each condition, whether the virtual ALL femoral tunnel and its trajectory violated the femoral cortex and the minimum distance between tunnels was investigated. Results Thirty-nine subjects were included. Overall violation rates of the femoral cortex by the ALL tunnels and its trajectories were 11.1% (195 of 1755 conditions) and 40.7% (714 of 1755 conditions), respectively. A drilling angle of axial 0° and coronal − 40° showed the longest minimum distance between tunnels without femoral cortex violation by the ALL tunnel (6.3 ± 4.0 mm; collision rate 2.6% [1 of 39 subjects]). With simultaneous consideration of the ALL tunnel's trajectory representing far-cortex drilling, a drill angle of axial 40° and coronal 10° showed the longest minimum distance between tunnels without femoral cortex violation (0.6 ± 3.9 mm; collision rate 38.5% [15 of 39 subjects]). For surgical techniques requiring far-cortex drilling, regression analyses were performed on geometric factors that could afect tunnel collision, which revealed that the sagittal inclination angle of the ACL and the distance between the ACL femoral tunnel's outlet and ALL's femoral attachment were associated with tunnel collision. ConclusionThe optimal drill orientations of the ALL femoral tunnel to minimize collision with the ACL femoral tunnel were axial 0° and coronal − 40° for surgical techniques not requiring far-cortex drilling and axial 40° and coronal 10° for techniques requiring far-cortex drilling. For techniques requiring far-cortex drilling, additional adjustment for orientation of the ACL femoral tunnel is required to reduce the risk of tunnel collision. Therefore, an individualized surgical strategy should be applied according to the graft ixation method of the ALL femoral tunnel.

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“…The anterolateral complex (ALC) of the knee has recently regained interest mainly due to the high revision rates in ACLR surgery, despite the recent concepts of anatomical and individualized ACL reconstruction and the vast improvements of fixation methods. [1][2][3][4] New evidence shows that ACLR revision rates remain unacceptably high, up to 18%, especially in the younger population. 5 These failures have a variety of factors, but one of the most concerning is the persisting anterolateral rotatory instability, which may not be fully restored with the current ACLR procedures.…”

Section: Introductionmentioning

confidence: 99%

A Review of Current Concepts of the Anterolateral Complex of the Knee

et al. 2022

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The anterolateral complex (ALC) of the knee has gained increased interest over the last decades due to the high revision rates of anterior cruciate ligament reconstruction (ACLR). Furthermore, in patients with an ACL tear, the injury of at least one of the ALC’s anatomic structures has been shown to be significantly higher, thus affecting its secondary stabilizing role at the knee joint. As such, ACLR augmentation techniques, that embrace the ALC, have been proposed recently, and indications for these procedures are still evolving. This review aims to present and discuss the most current anatomical, biomechanical, and imaging data, current reconstruction techniques, and the clinical results of ALC reconstruction.

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Research on the Anterolateral Ligament of the Knee: An Evaluation of PubMed Articles From 2010 to 2019

Cited by 6 publications

References 30 publications

Evaluation of the Anterolateral Ligament of the Knee in Magnetic Resonance Mri: Case Series

Evaluation of the Anterolateral Ligament of the Knee in Magnetic Resonance Mri: Case Series

The orientation of the ALL femoral tunnel to minimize collision with the ACL tunnel depends on the need or not of far-cortex drilling

A Review of Current Concepts of the Anterolateral Complex of the Knee

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