Abstract
Objective
This study evaluated the ability of routine 1.5-T MRI scans to visualize the anterolateral ligament (ALL) and describe its path and anatomic relations with lateral knee structures.
Materials and methods
Thirty-nine 1.5-T MRI scans of the knee were evaluated. The scans included an MRI knee protocol with T1-weighted sequences, T2-weighted sequences with fat saturation, and proton density (PD)-weighted fast spin-echo sequences. Two radiologists separately reviewed all MRI scans to evaluate interobserver reliability. The ALL was divided into three portions for analyses: femoral, meniscal, and tibial. The path of the ALL was evaluated with regard to known structural parameters previously studied in this region.
Results
At least a portion of the ALL was visualized in 38 (97.8 %) cases. The meniscal portion was most visualized (94.8 %), followed by the femoral (89.7 %) and the tibial (79.4 %) portions. The three portions of the ALL were visualized in 28 (71.7 %) patients. The ALL was characterized with greater clarity on the coronal plane and was visualized as a thin, linear structure. The T1-weighted sequences showed a statistically inferior ligament visibility frequency. With regard to the T2 and PD evaluations, although the visualization frequency in PD was higher for the three portions of the ligament, only the femoral portion showed significant values.
Conclusion
The ALL can be visualized in routine 1.5-T MRI scans. Although some of the ligament could be depicted in nearly all of the scans (97.4 %), it could only be observed in its entirety in about 71.7 % of the tests.
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References
Vincent JP, Magnussen RA, Gezmez F, et al. The anterolateral ligament of the human knee: an anatomic and histologic study. Knee Surg Sports Traumatol Arthrosc. 2012;20:147–52.
Vieira EL, Vieira EA, da Silva RT, Berlfein PA, Abdalla RJ, Cohen M. An anatomic study of the iliotibial tract. Arthroscopy. 2007;23:269–74.
Helito CP, Miyahara HS, Bonadio MB, et al. Anatomical study of the anterolateral ligament of the knee. Rev Bras Ortop. 2013;48:368–73.
Claes S, Vereecke E, Maes M, Victor J, Verdonk P, Bellemans J. Anatomy of the anterolateral ligament of the knee. J Anat. 2013;223:321–8.
Helito CP, Demange MK, Bonadio MB, et al. Anatomy and histology of the knee anterolateral ligament. Orthop J Sports Med. 2013;1:2325967113513546.
Monaco E, Ferretti A, Labianca L, et al. Navigated knee kinematics after cutting of the ACL and its secondary restraint. Knee Surg Sports Traumatol Arthrosc. 2012;20:870–7.
Weber MA. New aspects on the macroanatomy of anterolateral ligament structures of the knee and the implications for Segond fractures. Radiologe. 2013;53:1072–4.
Claes SA, Vereecke, Evie M, et al. The anterolateral ligament of the knee: anatomy, radiology, biomechanics and clinical implication. Poster session presented at AAOS Annual Meeting; 2013 Mar 19–23; Chicago, IL.
Gossner J. The anterolateral ligament of the knee: visibility on magnetic resonance imaging. Rev Bras Ortop. 2014;49:98–9.
Ayeni OR, Chahal M, Tran MN, Sprague S. Pivot shift as an outcome measure for ACL reconstruction: a systematic review. Knee Surg Sports Traumatol Arthrosc. 2012;20:767–7.
Watanabe AT, Carter BC, Teitelbaum GP, Seeger LL, Bradley Jr WG. Normal variations in MR imaging of the knee: appearance and frequency. AJR Am J Roentgenol. 1989;153:341–4.
Campos JC, Chung CB, Lektrakul N, et al. Pathogenesis of the Segond fracture: anatomic and MR imaging evidence of an iliotibial tract or anterior oblique band avulsion. Radiology. 2001;219:381–6.
Haims AH, Medvecky MJ, Pavlovich Jr R, Katz LD. MR imaging of the anatomy of and injuries to the lateral and posterolateral aspects of the knee. AJR Am J Roentgenol. 2003;180:647–53.
Helito CP, Demange MK, Helito PVP, et al. Assessment of the knee anterolateral ligament through MRI. Rev Bras Ortop (Epub ahead of print).
Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33:159–74.
Hussein M, van Eck CF, Cretnik A, Dinevski D, Fu FH. Prospective randomized clinical evaluation of conventional single-bundle, anatomic single-bundle, and anatomic double-bundle anterior cruciate ligament reconstruction: 281 cases with 3- to 5-year follow-up. Am J Sports Med. 2012;40:512–20.
Piefer JW, Pflugner TR, Hwang MD, Lubowitz JH. Anterior cruciate ligament femoral footprint anatomy: systematic review of the 21st century literature. Arthroscopy. 2012;28:872–81.
Scheffel PT, Henninger HB, Burks RT. Relationship of the intercondylar roof and the tibial footprint of the ACL: implications for ACL reconstruction. Am J Sports Med. 2013;41:396–401.
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Helito, C.P., Helito, P.V.P., Costa, H.P. et al. MRI evaluation of the anterolateral ligament of the knee: assessment in routine 1.5-T scans. Skeletal Radiol 43, 1421–1427 (2014). https://doi.org/10.1007/s00256-014-1966-7
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DOI: https://doi.org/10.1007/s00256-014-1966-7