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. 2019 Jan-Feb;53(1):89-93.
doi: 10.4103/ortho.IJOrtho_137_17.

The Anterolateral Ligament of the Knee: Descriptive Anatomy and Clinical Correlation

Shaifaly Madan Rustagi  1 , Parikshat Gopal  1 , Manish Singh Ahuja  1 , Naresh Chander Arora  1 , Nikhil Sood  1
Affiliations

The Anterolateral Ligament of the Knee: Descriptive Anatomy and Clinical Correlation

Shaifaly Madan Rustagi et al. Indian J Orthop. 2019 Jan-Feb.

Abstract

Background: The anterolateral ligament is a fibrous structure in the anterolateral aspect of the knee. Recently this liagament of the knee has gained spotlight in anatomical and imaging studies and has been designated as a new ligament of the knee joint. The anterolateral ligament (ALL) has been postulated to be a restraint against the anterolateral instability of the knee resulting in a positive pivot shift test. The purpose of this study is to provide detailed anatomical characteristics of ALL in the Indian population.

Materials and methods: The qualitative and quantitative characteristics of the ALL were observed in 20 embalmed cadaveric specimens. In all but one left male knee specimen (95%) ALL was observed. After isolating the ALL, its length, thickness, width, and points of attachments and dimensions of lateral collateral ligament (LCL) were determined.

Results: The ALL was consistently present in the anterolateral region of the knee separate from the joint capsule. Its proximal attachment to the femur is anterior and distal to the attachment of the LCL. Distally the superficial fibers of the ALL inserted close to the Gerdy's tubercle at the level of the fibular head, and the deeper fibers merged with the lateral meniscus. The mean length of the ALL was 43.35 mm ± 4.04 mm in flexion and 40.38 mm ± 4.35 mm in extension. The average width of the ALL was 6.98 mm ± 0.95 mm at its origin and 9.36 mm ± 1.07 mm at its insertion.

Conclusion: The ALL is hypothesized to affect internal tibial rotation and plays a role in the pivot shift phenomenon. ALL rupture could be responsible for rotatory laxity after isolated intraarticular reconstruction of the ACL.

Keywords: Anterolateral ligament; Gerdy's tubercle; Indian population; fibular collateral ligament; knee joint.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Right knee lateral aspect showing reflected Biceps femoris: BCF, Iliotibial tract: ITT, anterolateral ligament: ALL, Fibular collateral ligament: FCL, Tendon of popliteus: PLT Blue Star –Gerdy's tubercle
Figure 2
Figure 2
Left knee lateral aspect showing reflected Biceps femoris: BCF, Iliotibial tract: ITT, Anterolateral ligament: ALL, Fibular collateral ligament: FCL and Lateral femoral condyle: LFC
Figure 3
Figure 3
Right knee lateral aspect showing reflected Biceps femoris: BCF, Anterolateral ligament: ALL, Fibular collateral ligament: FCL Blue Star –Gerdy's tubercle, lateral meniscus lateral meniscus
Figure 4
Figure 4
Right knee lateral aspect showing reflected Biceps femoris BCF, Iliotibial tract ITT , anterolateral ligament ALL,Fibular collateral ligament FCL , Lateral Meniscus LM , cut end popliteus tendon PLT, Lateral femoral condyle LFC Lateral tibial condyle LTC Gerdyæs tubercle GT Encircled: Lateral inferior genicular Artery and Vein
See this image and copyright information in PMC

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