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. 2016 Feb 22;5(1):e185-8.
doi: 10.1016/j.eats.2015.10.019. eCollection 2016 Feb.

Surgical Dissection of the Anterolateral Ligament

Matthew Daggett  1 , Kyle Busch  1 , Bertrand Sonnery-Cottet  2
Affiliations

Surgical Dissection of the Anterolateral Ligament

Matthew Daggett et al. Arthrosc Tech. .

Abstract

Recent investigations into the structure and function of the anterolateral ligament (ALL) have resulted in renewed interest in the role of the lateral extra-articular structures in rotational control of the knee. With increased focus on the ALL, debate about the anatomic characteristics, the functional role in knee stability, and even the existence of this lateral structure has ensued. This article describes our dissection method for the ALL. Through careful dissection and precise elevation of the iliotibial band, the ALL can be clearly identified as a distinct structure with an attachment near the lateral epicondyle on the femur and an insertion in a fan-like fashion onto the tibia, between the Gerdy tubercle and the fibular head. This investigation provides the surgeon with anatomic landmarks to use during surgical reconstruction of the ALL.

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Figures

Fig 1
Fig 1
Identification of the iliotibial band, Gerdy tubercle, and fibular head is necessary for dissection of the anterolateral ligament (right knee specimen in supine position).
Fig 2
Fig 2
Careful reflection of the iliotibial band to the Gerdy tubercle is required for visualization of the anterolateral ligament (right knee specimen in supine position). The fibers of the anterolateral ligament are often in close proximity to the deep fibers of the iliotibial band, and meticulous dissection is required to isolate these two structures.
Fig 3
Fig 3
Reflection of the biceps femoris (BF) and posterior capsulectomy are performed to identify the posterior border of the anterolateral ligament (ALL) (right knee specimen in supine position).
Fig 4
Fig 4
After completion of the posterior capsulectomy, the capsule anterior to the anterolateral ligament (ALL) can be removed (right knee specimen in supine position). (BF, biceps femoris; LCL, lateral collateral ligament.)
Fig 5
Fig 5
After careful dissection, the entirety of the anterolateral ligament (ALL) can be identified as it overlaps the lateral collateral ligament (LCL) (right knee specimen in supine position). The ALL originates near the lateral epicondyle (LE) and inserts onto the tibia between the Gerdy tubercle and the fibular head.
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