The magnetic resonance imaging appearance of the anterolateral ligament of the knee in association with anterior cruciate rupture

Abstract

ALL injury was identified in only one-tenth of cases of ACL rupture. MRI changes can be reliably identified with strong agreement between observers. ALL injury is found more frequently on MRI within 6 weeks of the knee injury (compared to scans performed after this time period) suggesting that some injuries may resolve or become less visible.

Risk factors for residual anterolateral rotational instability after double bundle anterior cruciate ligament reconstruction: Evaluation by quantitative assessment of the pivot shift phenomenon using triaxial accelerometer

“…The reason meniscal tears did not have a significant relationship with residual ALRI might have been because most of the meniscal tears were repaired instead of meniscectomy. Factors regarding anterolateral structure or iliotibial tract injury were not investigated in the present study because the sensitivity and specificity of detecting these damages with image evaluation remain controversial [22][23][24]. As for the ATT side-to-side difference, it showed weak negative association with absolute residual acceleration based on univariate analysis, however, multivariate analysis showed no correlation between them.…”

An Overview of Anatomy and Imaging of the Anterolateral Structures of the Knee

“…Therefore, criteria for injuries of similar ligamentous structures are used to define ALL tears, such as peripheral edema, irregularity of fibers, discontinuity, and bone avulsions. 7 , 33 , 36 – 38 , 55 – 57 The bone avulsion occurs at its distal insertion and corresponds to Segond fractures according to some authors 1 , 35 , 58 , 59 (Fig. 7 ).…”

“… 37 Some studies failed to identify the association between ALL MRI abnormalities and lateral meniscus tears in patients with a ruptured ACL, which makes this association still a matter of controversy. 37 , 55 Although not statistically significant, Kosy et al 55 showed a tendency of higher incidence of lateral meniscus tears in association with ALL abnormalities, which may be caused by the rotational stress in ACL injuries.…”

“… 36 – 38 , 57 Controversy is also found with regard to the location of the ALL injury, although it is not clear whether this is clinically relevant. Although the majority of studies have found the tibial portion to be more frequently injured, 21 , 38 , 55 1 study identified more injuries in the femoral portion. 36 Segond fractures represent a minority of injuries in most studies.…”

Imaging of Ligamentous Structures within the Knee Includes Much More Than the ACL

“…62 Another study showed good interobserver reliability in identifying injuries, but that only 10% of patients with a torn ACL have an injured ALL. 59,64 Some of the recent attention paid to the ALL in the literature is related to some authors' claims that it might cause the avulsion portion of a Segond fracture. The Segond fracture has historically been thought to be due to avulsion of the joint capsule attachment, but recent studies have shown that the ALL is usually attached to the Segond fracture fragment, and that the iliotibial band may also be involved.…”