Ultrasonographic Evaluation of Anterolateral Ligament Injuries: Correlation With Magnetic Resonance Imaging and Pivot-Shift Testing

Cavaignac, Étienne; Faruch, Marie; Wytrykowski, Karine; Constant, Olivia; Murgier, Jérôme; Bérard, Emilie; Chiron, Philippe

doi:10.1016/j.arthro.2017.01.040

Cited by 63 publications

(92 citation statements)

References 33 publications

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“…The prevalence of concomitant anterolateral structure lesions in acute ACL injuries have been reported to vary from 40% to 90% depending on the chosen method of detection. [5,13,17].…”

Section: Biomechanics Of Lateralmentioning

confidence: 99%

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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“…The prevalence of concomitant anterolateral structure lesions in acute ACL injuries have been reported to vary from 40% to 90% depending on the chosen method of detection. [5,13,17].…”

Section: Biomechanics Of Lateralmentioning

confidence: 99%

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

View full text Add to dashboard Cite

show abstract

“…For US, the tibial portion of the ALL was better detected than the femoral and meniscal portions. Cavaignac et al 22 compared the diagnostic ability of ultrasonography and MRI to detect ALL injuries in 30 patients with an isolated ACL injury. They argued that, at US, the ALL was visible over its entire length in 100% of patients and it appeared injured in 63% of the cases; on MRI, the ALL was visible in 96% of patients, and it appeared injured in 53% of the cases.…”

Section: Discussionmentioning

confidence: 99%

Sonographic Evaluation of the Anterolateral Ligament of the Knee: A Cadaveric Study

et al. 2018

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Rotational stability of the knee involves not only the cruciate ligaments but also another structure named anterolateral ligament (ALL), the function of which is still controversial. This study evaluated the effectiveness of high-resolution ultrasound (US) examination to detect the ALL. We studied 8 cadaveric knees (8 ALLs). On each knee, high-resolution real-time ultrasonography examination was performed by an experienced musculoskeletal radiologist before and after the procedure, with the surgeons blind to the results of the scan both before and after dissection. The ALL was identified in each cadaver limb by the musculoskeletal radiologist. US is a useful imaging modality to identify and evaluate the ALL. The ability of US to fully evaluate injuries involving the ALL still needs to be demonstrated in a clinical setting.

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“…6B). Some studies have shown that both a normal and injured ALL can be visualized on ultrasound, 58,59 although sonography currently is not widely used for evaluation.…”

Section: Anterolateral Ligament Normal Imaging Appearancesmentioning

confidence: 99%

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

Gaetke‐Udager

Yablon

2018

J Knee Surg

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Ligamentous structures of the knee are numerous and complex, including the anterior and posterior cruciate ligaments, medial and lateral collateral ligaments, ligaments of the posteromedial and posterolateral corners, and the anterolateral ligament. Clinical assessment after a knee injury is paramount and can direct both the clinician's choice of imaging study and the radiologist's interpretation. Imaging is crucial in that it provides additional information for diagnosis, management, and surgical planning. Multiple imaging modalities can be used in the evaluation of the knee injuries, with radiographs an important baseline study, magnetic resonance imaging as the best tool for a comprehensive assessment including cruciate ligament evaluation, and ultrasound useful in evaluating superficial structures. Knowledge of both normal and pathological appearances of ligamentous structures, as well as typical injury patterns, is useful not only for radiologists but also for clinicians who manage patients with knee pain.

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Ultrasonographic Evaluation of Anterolateral Ligament Injuries: Correlation With Magnetic Resonance Imaging and Pivot-Shift Testing

Cited by 63 publications

References 33 publications

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

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

Sonographic Evaluation of the Anterolateral Ligament of the Knee: A Cadaveric Study

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

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