2017 ISAKOS Biennial Congress ePoster #1605

 

Anterolateral Ligament: Anatomy and Length Variation During Motion

Thomas Neri, MD, PhD, Asst. Prof., Saint-Etienne FRANCE
Fabien Palpacuer, PT, Saint Etienne FRANCE
Frederic Farizon, St Etienne Cedex 2 FRANCE
Remi Philippot, MD, PhD, Prof, Saint Priest en Jarez FRANCE

Laboratoire Interuniversitaire Biologie Motricité, university hospital of Saint etienne, Saint etienne, FRANCE

FDA Status Not Applicable

Summary

The objective of this study was to propose an accurate anatomical description of the anterolateral ligament.

Abstract

The existence of the anterolateral ligament (ALL) remains controversial and his anatomical description is not unanimous. The objective of this study was to propose an accurate anatomical description of the ALL.

Methods

This was a study including 42 cadaveric knees. The tibial and femoral inserts have been described with respect to adjacent structures. The length and thickness of the ligament were measured in different positions of flexion and knee rotation (extension and flexion 30-60-90 ° each time with neutral rotation, medial or lateral 30°).

Results

The ALL was found in 40 cases. The femoral insertion, medium width 8.88 ± 1.15 mm, was posterior (8.75 ± 1.04 mm) and proximal to the popliteus tendon (PT), and slightly posterior (5.77 ± 0.93 mm) than the lateral collateral ligament (LCL). At their femoral insertion, there were connections between the LCL and ALL, sometimes giving a common insertion appearance. At the joint space width was 7.28 ± 1.09 mm, and there was an inseparable connection with the capsule and the average horn of the lateral meniscus.
The tibial insertion, of greater width (p <0.001) was posterior (20.54 ± 1.35 mm) and distal (3.81 ± 0.85 mm) to the tubercle of Gerdy, anterior (25.61 ± 1.72 mm) and proximal to the distal fibular head and distal (11.15 ± 2.01 mm) to the tibial articular cartilage. The thickness was constant (1.38 ± 0.23 mm). The average length increased significantly with flexion and internal rotation (p <0.001), from 38.93 ± 5.12 mm in extension (minimum value), to 42.23 ± 3.08 mm at 90 ° of flexion and neutral rotation, and to 44.72 ± 3.66 mm at 90 ° of flexion and 30 ° of internal rotation (maximum value). There was a significant correlation between the length of the ALL and the size of the subjects and with the dimensions of the proximal femur (epicondylar width and the intercondylar notch) (p <0.001). There was no correlation with the dimensions of the proximal end of the tibia.

Discussion

ALL is a separate structure antero-lateral, which is inserted in front of the LCL and behind the farm and back ends of Gerdy's tubercle. Its length varies with flexion and rotation, to be maximal at 90 ° of flexion and 30 ° of internal rotation and appears to be correlated to the size of the subject.

Conclusion

Further studies are needed to determine role of tle ALL in the stability of the knee.