Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 20, Issue 1, pp 147–152 | Cite as

The anterolateral ligament of the human knee: an anatomic and histologic study

  • Jean-Philippe Vincent
  • Robert A. Magnussen
  • Ferittu Gezmez
  • Arnaud Uguen
  • Matthias Jacobi
  • Florent Weppe
  • Ma’ad F. Al-Saati
  • Sébastien Lustig
  • Guillaume Demey
  • Elvire Servien
  • Philippe Neyret
Knee

Abstract

Purpose

The functional anatomy of the knee is frequently studied but remains incompletely understood. Numerous authors have described a structure in the lateral knee connecting the lateral femoral condyle with the lateral meniscus and tibial plateau. The goal of this study is to define the incidence, anatomy, and histology of this structure, the anterolateral ligament.

Methods

The incidence of the ligament was determined in 30 consecutive patients undergoing total knee arthroplasty (TKA) for medial compartment osteoarthritis. The anatomy and histology were evaluated using 10 cadaveric knees.

Results

The anterolateral ligament was noted to be present in all 40 knees. In all cases, it was noted to take origin near or on the popliteus tendon insertion and insert into the lateral meniscus and tibial plateau 5 mm distal to the articular surface and posterior to Gerdy’s Tubercle. The average width of the relatively flat structure was 8.2 ± 1.5 mm, and the average length was 34.1 ± 3.4 mm. Histologic analysis revealed a discreet structure with a fibrous core surrounded by synovium. Fibers blended with the popliteus at its origin and with the lateral meniscus as it passed distally.

Conclusions

The anterolateral ligament may play a role in preventing anterior tibial translation. The role, if any, of this structure in meniscal stability and the pathology of meniscal tears remain unclear.

Level of evidence

Not applicable—Descriptive Anatomic Study.

Keywords

Knee Anatomy Anterolateral ligament Stability 

References

  1. 1.
    Amis AA (2007) Current concepts on anatomy and biomechanics of patellar stability. Sports Med Arthrosc 15:48–56PubMedCrossRefGoogle Scholar
  2. 2.
    Campos JC, Chung CB, Lektrakul N, Pedowitz R, Trudell D, Yu J, Resnick D (2001) Pathogenesis of the Segond fracture: anatomic and MR imaging evidence of an iliotibial tract or anterior oblique band avulsion. Radiology 219:381–386PubMedGoogle Scholar
  3. 3.
    Clarke HD, Fuchs R, Scuderi GR, Scott WN, Insall JN (2005) Clinical results in valgus total knee arthroplasty with the “pie crust” technique of lateral soft tissue releases. J Arthroplasty 20:1010–1014PubMedCrossRefGoogle Scholar
  4. 4.
    Fairclough J, Hayashi K, Toumi H, Lyons K, Bydder G, Phillips N, Best TM, Benjamin M (2006) The functional anatomy of the iliotibial band during flexion and extension of the knee: implications for understanding iliotibial band syndrome. J Anat 208:309–316PubMedCrossRefGoogle Scholar
  5. 5.
    Hughston JC, Andrews JR, Cross MJ, Moschi A (1976) Classification of knee ligament instabilities. Part II. The lateral compartment. J Bone Joint Surg Am 58:173–179PubMedGoogle Scholar
  6. 6.
    Johnson LL (1979) Lateral capsular ligament complex: anatomical and surgical considerations. Am J Sports Med 7:156–160PubMedCrossRefGoogle Scholar
  7. 7.
    LaPrade RF, Gilbert TJ, Bollom TS, Wentorf F, Chaljub G (2000) The magnetic resonance imaging appearance of individual structures of the posterolateral knee. A prospective study of normal knees and knees with surgically verified grade III injuries. Am J Sports Med 28:191–199PubMedGoogle Scholar
  8. 8.
    Last RJ (1948) Some anatomical details of the knee joint. J Bone Joint Surg Br 30B:683–688PubMedGoogle Scholar
  9. 9.
    Sanchez AR II, Sugalski MT, LaPrade RF (2006) Anatomy and biomechanics of the lateral side of the knee. Sports Med Arthrosc 14:2–11PubMedCrossRefGoogle Scholar
  10. 10.
    Seebacher JR, Inglis AE, Marshall JL, Warren RF (1982) The structure of the posterolateral aspect of the knee. J Bone Joint Surg Am 64:536–541PubMedGoogle Scholar
  11. 11.
    Segond P (1879) Recherches cliniques et expérimentales sur les épanchements sanguins du genou par entorse. Progrès Med 7:297–341Google Scholar
  12. 12.
    Terry GC, Hughston JC, Norwood LA (1986) The anatomy of the iliopatellar band and iliotibial tract. Am J Sports Med 14:39–45PubMedCrossRefGoogle Scholar
  13. 13.
    Terry GC, LaPrade RF (1996) The posterolateral aspect of the knee. Anatomy and surgical approach. Am J Sports Med 24:732–739PubMedCrossRefGoogle Scholar
  14. 14.
    Terry GC, Norwood LA, Hughston JC, Caldwell KM (1993) How iliotibial tract injuries of the knee combine with acute anterior cruciate ligament tears to influence abnormal anterior tibial displacement. Am J Sports Med 21:55–60PubMedCrossRefGoogle Scholar
  15. 15.
    Vieira EL, Vieira EA, da Silva RT, Berlfein PA, Abdalla RJ, Cohen M (2007) An anatomic study of the iliotibial tract. Arthroscopy 23:269–274PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Jean-Philippe Vincent
    • 1
  • Robert A. Magnussen
    • 2
  • Ferittu Gezmez
    • 2
  • Arnaud Uguen
    • 1
  • Matthias Jacobi
    • 2
  • Florent Weppe
    • 2
  • Ma’ad F. Al-Saati
    • 2
  • Sébastien Lustig
    • 2
  • Guillaume Demey
    • 2
  • Elvire Servien
    • 2
  • Philippe Neyret
    • 2
  1. 1.Centre Hospitalier Universitaire BrestBrestFrance
  2. 2.Hopital de la Croix-RousseLyonFrance

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