The anterolateral complex of the knee: a pictorial essay

Abstract

Injuries to the anterolateral complex of the knee can result in increased rotatory knee instability. However, to diagnose and treat patients with persistent instability properly, surgeons need to understand the multifactorial genesis as well as the complex anatomy of the anterolateral aspect of the knee in its entirety. While recent research focused primarily on one structure (anterolateral ligament-ALL), the purpose of this pictorial essay is to provide a detailed layer-by-layer description of the anterolateral complex of the knee, consisting of the iliotibial band with its superficial, middle, deep, and capsulo-osseous layer as well as the anterolateral joint capsule. This may help surgeons to not only understand the anatomy of this particular part of the knee, but may also provide guidance when performing extra-articular procedures in patients with rotatory knee instability. Level of evidence V.

ACL or ACL+

“…Some authors have characterized the ALL as just one component of an anterolateral capsular complex. 10,13 Others have stressed the role of the deep fibers of the iliotibial tract, which possesses both femoral and tibial attachments. These are often eponymously referred to as Kaplan fibers, after the American anatomist Emanuel Kaplan.…”

Modified Lemaire extra-articular stabilisation of the knee for the treatment of anterolateral instability combined with diffuse pigmented villonodular synovitis: a case report

“…The pivot-shift phenomenon is considered to have a multi-factorial pathogenic background in many cases. Contributing factors may include ligamentous laxity, altered bone morphology, and other soft tissue injuries [ 24 – 26 ]. Succeeding careful consideration of these factors, the pivot-shift test can be considered a reliable examination to evaluate rotational laxity.…”

Comment to the Article “Mid-Term Results of Simultaneous Reconstruction of Anterior Cruciate and Anterolateral Ligaments in Athletes”

“…Однако не все авторы выделяют эту связку как самостоятельную анатомическую струк-туру. Так, E. Herbst с соавторами при исследовании 20 кадаверных препаратов сообщили об отсутствии четкой анатомической структуры передне-латеральной связки и описали ее как часть капсулы коленного сустава [13].…”