The anterolateral ligament (ALL) Anatomy of the knee The anterolateral ligament (ALL) Author : Radu Branea Co-author : Feier Andrei, Al Hussein Hussam, Tăbăcar Mircea Scientific coordonator : dr. Adrian Ivănescu

History 1879-Paul Segond: “pearly, resistant, fibrous band”[1] (mid-third) lateral capsular ligament Capsulo-osseous layer of the iliotibial band Anterolateral ligament

Anatomy The anterolateral ligament (ALL) is located on the lateral region of the knee, anterior to the lateral collateral ligament (LCL) and posterior to Gerdy’s tubercle. Origin: lateral epicondyle[1] or condyle[2] of the femur Insertion: anterolateral aspect of the proximal tibia, with 2 attachements

Background common procedure of orthopedics surgery : ACL reconstruction even after reconstruction,some patients experience tough anterolateral rotatory movement (pivot shifting)[1],[3] role of ALL : seems to stabilize medial rotation of the knee[1],[3]

Objective to provide an anatomical description of the anterolateral ligament of the knee (ALL) and describe its clinical correlations

Material and method Eight paired cadaveric knees belonging to the Anatomy Department One amputated lower limb from the Pathology Department dissected in the anterolateral region; The ALL was clearly observable

What we found ITB=Iliotibial Band GT=Gerdy’s Tubercle LFE=Lateral Femoral Epicondyle LCL=Lateral Collateral Ligament FH=Fibular Head

Results Origin: Lateral Femoral Epicondyle(LFE) Insertion: 1.proximal tibia, between Gerdy’s tubercle(GT) and fibular head(FH); 2. Lateral meniscus Closely related to the LCL, however independent

Results Measurements Length(mm) 38 Width(mm) 7 Thickness(mm) 3

Conclusions Formerly known as only a fascia, the ALL could now prove to be a lot more than that Possible involvement in ACL(Anterior Cruciate Ligament) related sports injuries

Discussions Pros: - new subject - emphasize the existence of the ALL starting point for detailed orthopaedic studies Cons: - ethics - small number of dissections

Bibliography [1] Claes, S.; Vereecke, E.; Maes, M.; Victor, J.; Verdonk, P.; Bellemans, J. (Oct 2013). "Anatomy of the anterolateral ligament of the knee.". J Anat 223 (4): 321–8 [2] Vincent, J. P.; Magnussen, R. A.; Gezmez, F.; et al. (January 2012). "The anterolateral ligament of the human knee: An anatomic and histologic study". Knee Surg Sports Traumatol Arthrosc 20 (1): 147–52. [3] Helito, C. P., de Souza, H. M., Batista, M., et al. “Anatomical study on the anterolateral ligament of the knee”, Revista Brasileira de Ortopedia, 2013; 48: 368–373 [4] Helito, C. P., Demange, M. K., Batista, M, et al.,” Anatomy and Histology of the Knee Anterolateral Ligament”, 2013, 1

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