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. 2020 Mar;27(2):363-374.
doi: 10.1016/j.knee.2019.11.018. Epub 2019 Dec 23.

Knee laxity in anterolateral complex injuries versus lateral meniscus posterior horn injuries in anterior cruciate ligament deficient knees: A cadaveric study

Ji Hyun Ahn  1 , In Jun Koh  2 , Michelle H McGarry  3 , Nilay A Patel  4 , Charles C Lin  5 , Thay Q Lee  3 , Sangwoo Kim  6
Affiliations

Knee laxity in anterolateral complex injuries versus lateral meniscus posterior horn injuries in anterior cruciate ligament deficient knees: A cadaveric study

Ji Hyun Ahn et al. Knee. 2020 Mar.

Abstract

Background: In the anterior cruciate ligament (ACL) injured knee, additional injury of the anterolateral ligament (ALL) and capsule may increase the pathologic laxity. The purpose of this study was to compare the effects of the anterolateral complex (ALC) injury in ACL injured knee with the effects of lateral meniscus posterior horn (LMPH) meniscectomy.

Methods: Ten fresh-frozen cadaveric knees were used. After testing the (1) intact knees and (2) ACL sectioned knees (ACL-), two groups were established: an (3) ALC sectioning group (n = 5), which underwent additional ALC sectioning (ACL-/ALC-) after ACL sectioning, and a separate (3) LMPH meniscectomy group (n = 5) that underwent LMPH meniscectomy (ACL-/LMPH-) after ACL sectioning. Knee laxity was measured in terms of internal-external rotation, anterior-posterior translation, and varus-valgus angulation for each condition at knee flexion angles of 0°, 30°, 60° and 90°.

Results: After additional sectioning of the ALC (ACL-/ALC-), the mean internal rotation at 0, 30, 60 and 90° of knee flexion was 11.9 ± 1.3°, 18.1 ± 1.6°, 18.3 ± 1.8°, and 17.8 ± 2.4°, respectively, showing significant internal rotation laxity when compared to the intact knee (P = .031, .020, .001 and .033). Anterior translation also significantly increased compared to the ACL- knee at 30° (12.7 ± 1.4 to 16.8 ± 1.7 mm: P = .039). In contrast, additional meniscectomy of the LMPH (ACL-/LMPH-) significantly increased valgus laxity compared to the intact knee at 30, 60 and 90° (P = .021, .018 and .024).

Conclusion: These findings suggest that the anterolateral complex, which include the ALL and anterolateral capsule, may play an important role in stabilizing the knee against internal rotation and anterior translation.

Keywords: Anterior cruciate ligament; Anterolateral capsule; Anterolateral ligament; Knee laxity.

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Conflict of interest statement

Declaration of competing interest Ji Hyun Ahn and Thay Q. Lee have received research grants from Smith and Nephew Company. Ji Hyun Ahn has also received research grants from Dongguk University. In Jun Koh, Michelle H. McGarry, Nilay A. Patel, Charles C. Lin and Sangwoo Kim declare that they have no conflict of interest. All authors do not have any financial and personal relationships with other people or organizations that could inappropriately influence the current work.

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