Advertisement

Anterolateral rotatory instability of the knee

Abstract

Recent publications have generated renewed interest in the anatomy of the anterolateral capsule. Knowledge of the biomechanical function of the anterolateral components is lacking. Further research is required to evaluate the influence of the anterolateral capsule on rotatory laxity of the knee. The role of surgical procedures, such as an extra-articular tenodesis or lateral plasty, has to be defined based on quantification of the injury. This article seeks to summarize the current literature and discusses the role of the anterolateral capsule and reconstructive techniques in combined ligamentous knee trauma.

Level of evidence V.

This is a preview of subscription content, log in to check access.

Access options

Buy single article

Instant unlimited access to the full article PDF.

US$ 39.95

Price includes VAT for USA

Subscribe to journal

Immediate online access to all issues from 2019. Subscription will auto renew annually.

US$ 199

This is the net price. Taxes to be calculated in checkout.

Fig. 1
Fig. 2

References

  1. 1.

    Anderson AF, Snyder RB, Lipscomb AB Jr (2001) Anterior cruciate ligament reconstruction. A prospective randomized study of three surgical methods. Am J Sports Med 29(3):272–279

  2. 2.

    Araujo PH, Ahlden M, Hoshino Y, Muller B, Moloney G, Fu FH, Musahl V (2012) Comparison of three non-invasive quantitative measurement systems for the pivot shift test. Knee Surg Sports Traumatol Arthrosc 20(4):692–697

  3. 3.

    Bedi A, Musahl V, Lane C, Citak M, Warren RF, Pearle AD (2010) Lateral compartment translation predicts the grade of pivot shift: a cadaveric and clinical analysis. Knee Surg Sports Traumatol Arthrosc 18(9):1269–1276

  4. 4.

    Bertoia JT, Urovitz EP, Richards RR, Gross AE (1985) Anterior cruciate reconstruction using the MacIntosh lateral-substitution over-the-top repair. J Bone Joint Surg Am 67(8):1183–1188

  5. 5.

    Bignozzi S, Zaffagnini S, Lopomo N, Martelli S, Iacono F, Marcacci M (2009) Does a lateral plasty control coupled translation during antero-posterior stress in single-bundle ACL reconstruction? An in vivo study. Knee Surg Sports Traumatol Arthrosc 17(1):65–70

  6. 6.

    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(2):381–386

  7. 7.

    Caterine S, Litchfield R, Johnson M, Chronik B, Getgood A (2014) A cadaveric study of the anterolateral ligament: re-introducing the lateral capsular ligament. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-014-3117-z

  8. 8.

    Cianca J, John J, Pandit S, Chiou-Tan FY (2014) Musculoskeletal ultrasound imaging of the recently described anterolateral ligament of the knee. Am J Phys Med Rehabil 93(2):186

  9. 9.

    Claes S, Luyckx T, Vereecke E, Bellemans J (2014) The Segond fracture: a bony injury of the anterolateral ligament of the knee. Arthroscopy. doi:10.1016/j.arthro.2014.05.039

  10. 10.

    Claes S, Vereecke E, Maes M, Victor J, Verdonk P, Bellemans J (2013) Anatomy of the anterolateral ligament of the knee. J Anat 223(4):321–328

  11. 11.

    Colombet P (2011) Knee laxity control in revision anterior cruciate ligament reconstruction versus anterior cruciate ligament reconstruction and lateral tenodesis: clinical assessment using computer-assisted navigation. Am J Sports Med 39(6):1248–1254

  12. 12.

    De Maeseneer M, Boulet C, Willekens I, Lenchik L, De Mey J, Cattrysse E, Shahabpour M (2014) Segond fracture: involvement of the iliotibial band, anterolateral ligament, and anterior arm of the biceps femoris in knee trauma. Skeletal Radiol. doi:10.1007/s00256-014-2044-x

  13. 13.

    Dodds AL, Halewood C, Gupte CM, Williams A, Amis AA (2014) The anterolateral ligament: anatomy, length changes and association with the Segond fracture. Bone Joint J 96-B(3):325–331

  14. 14.

    Dombrowski ME, Costello JM, Ohashi B, Murawski CD, Rothrauff BB, Arilla FV, Friel NA, Fu FH, Debski RE, Musahl V (2015) Macroscopic anatomical, histological and magnetic resonance imaging correlation of the lateral capsule of the knee. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-015-3517-8

  15. 15.

    Draganich LF, Reider B, Ling M, Samuelson M (1990) An in vitro study of an intraarticular and extraarticular reconstruction in the anterior cruciate ligament deficient knee. Am J Sports Med 18(3):262–266

  16. 16.

    Duthon VB, Magnussen RA, Servien E, Neyret P (2013) ACL reconstruction and extra-articular tenodesis. Clin Sports Med 32(1):141–153

  17. 17.

    Engebretsen L, Lew WD, Lewis JL, Hunter RE (1990) The effect of an iliotibial tenodesis on intraarticular graft forces and knee joint motion. Am J Sports Med 18(2):169–176

  18. 18.

    Haims AH, Medvecky MJ, Pavlovich R Jr, Katz LD (2003) MR imaging of the anatomy of and injuries to the lateral and posterolateral aspects of the knee. AJR Am J Roentgenol 180(3):647–653

  19. 19.

    Helito CP, Demange MK, Bonadio MB, Tirico LE, Gobbi RG, Pecora JR, Camanho GL (2014) Radiographic landmarks for locating the femoral origin and tibial insertion of the knee anterolateral ligament. Am J Sports Med 42(10):2356–2362. doi:10.1177/0363546514543770

  20. 20.

    Helito CPDM, Bonadio MB, Tirico LEP, Gobbi RG, Pecora JR, Camanho GL (2013) Anatomy and histology of the knee anterolateral ligament. Orthop J Sports Med 1(7):2325967113513546

  21. 21.

    Helito CP, Helito PV, Costa HP, Bordalo-Rodrigues M, Pecora JR, Camanho GL, Demange MK (2014) MRI evaluation of the anterolateral ligament of the knee: assessment in routine 1.5-T scans. Skeletal Radiol 43(10):1421–1427

  22. 22.

    Hoshino Y, Araujo P, Ahlden M, Moore CG, Kuroda R, Zaffagnini S, Karlsson J, Fu FH, Musahl V (2012) Standardized pivot shift test improves measurement accuracy. Knee Surg Sports Traumatol Arthrosc 20(4):732–736

  23. 23.

    Hoshino Y, Araujo P, Ahlden M, Samuelsson K, Muller B, Hofbauer M, Wolf MR, Irrgang JJ, Fu FH, Musahl V (2013) Quantitative evaluation of the pivot shift by image analysis using the iPad. Knee Surg Sports Traumatol Arthrosc 21(4):975–980

  24. 24.

    Hoshino Y, Kuroda R, Nagamune K, Araki D, Kubo S, Yamaguchi M, Kurosaka M (2012) Optimal measurement of clinical rotational test for evaluating anterior cruciate ligament insufficiency. Knee Surg Sports Traumatol Arthrosc 20(7):1323–1330

  25. 25.

    Hughston JC, Andrews JR, Cross MJ, Moschi A (1976) Classification of knee ligament instabilities. Part I. The medial compartment and cruciate ligaments. J Bone Joint Surg Am 58(2):159–172

  26. 26.

    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(2):173–179

  27. 27.

    Irvine GB, Dias JJ, Finlay DB (1987) Segond fractures of the lateral tibial condyle: brief report. J Bone Joint Surg Br 69(4):613–614

  28. 28.

    Johnson LL (1979) Lateral capsular ligament complex: anatomical and surgical considerations. Am J Sports Med 7(3):156–160

  29. 29.

    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(2):191–199

  30. 30.

    LaPrade RF, Ly TV, Wentorf FA, Engebretsen L (2003) The posterolateral attachments of the knee: a qualitative and quantitative morphologic analysis of the fibular collateral ligament, popliteus tendon, popliteofibular ligament, and lateral gastrocnemius tendon. Am J Sports Med 31(6):854–860

  31. 31.

    LaPrade RF, Terry GC (1997) Injuries to the posterolateral aspect of the knee. Association of anatomic injury patterns with clinical instability. Am J Sports Med 25(4):433–438

  32. 32.

    Lemaire M, Combelles F (1980) Plastic repair with fascia lata for old tears of the anterior cruciate ligament (author’s transl). Rev Chir Orthop Reparatrice Appar Mot 66(8):523–525

  33. 33.

    Lopomo N, Signorelli C, Bonanzinga T, Marcheggiani Muccioli GM, Neri MP, Visani A, Marcacci M, Zaffagnini S (2014) Can rotatory knee laxity be predicted in isolated anterior cruciate ligament surgery? Int Orthop 38(6):1167–1172. doi:10.1007/s00264-014-2287-0

  34. 34.

    Lopomo N, Zaffagnini S, Signorelli C, Bignozzi S, Giordano G, Marcheggiani Muccioli GM, Visani A (2012) An original clinical methodology for non-invasive assessment of pivot-shift test. Comput Methods Biomech Biomed Eng 15(12):1323–1328

  35. 35.

    Marcacci M, Zaffagnini S, Giordano G, Iacono F, Presti ML (2009) Anterior cruciate ligament reconstruction associated with extra-articular tenodesis: a prospective clinical and radiographic evaluation with 10- to 13-year follow-up. Am J Sports Med 37(4):707–714

  36. 36.

    Martens M (2013) The extra-articular lateral tenodesis for an ACL-deficient knee. Aspetar Sports Med J 2(TT1–Football Injuries):170–175

  37. 37.

    Monaco E, Ferretti A, Labianca L, Maestri B, Speranza A, Kelly MJ, D’Arrigo C (2012) Navigated knee kinematics after cutting of the ACL and its secondary restraint. Knee Surg Sports Traumatol Arthrosc 20(5):870–877

  38. 38.

    Monaco E, Maestri B, Conteduca F, Mazza D, Iorio C, Ferretti A (2014) Extra-articular ACL reconstruction and pivot shift: in vivo dynamic evaluation with navigation. Am J Sports Med 42(7):1669–1674

  39. 39.

    Moorman CT 3rd, LaPrade RF (2005) Anatomy and biomechanics of the posterolateral corner of the knee. J Knee Surg 18(2):137–145

  40. 40.

    Musahl V, Zaffagnini S, Becker R, Karlsson J (2014) Should peripheral structures be addressed in ACL reconstruction? Knee Surg Sports Traumatol Arthrosc 22(9):1964–1965

  41. 41.

    Parsons EM, Gee AO, Spiekerman C, Cavanagh PR (2015) The biomechanical function of the anterolateral ligament of the knee. Am J Sports Med 43(3):669–674

  42. 42.

    Pernin J, Verdonk P, Si Selmi TA, Massin P, Neyret P (2010) Long-term follow-up of 24.5 years after intra-articular anterior cruciate ligament reconstruction with lateral extra-articular augmentation. Am J Sports Med 38(6):1094–1102

  43. 43.

    Pomajzl R, Maerz T, Shams C, Guettler J, Bicos J (2014) A review of the anterolateral ligament of the knee: current knowledge regarding its incidence, anatomy, biomechanics, and surgical dissection. Arthroscopy. doi:10.1016/j.arthro.2014.09.010

  44. 44.

    Rezansoff AJ, Caterine S, Spencer L, Tran MN, Litchfield RB, Getgood AM (2014) Radiographic landmarks for surgical reconstruction of the anterolateral ligament of the knee. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-014-3126-y

  45. 45.

    Russell DF, Deakin AH, Fogg QA, Picard F (2014) Repeatability and accuracy of a non-invasive method of measuring internal and external rotation of the tibia. Knee Surg Sports Traumatol Arthrosc 22(8):1771–1777

  46. 46.

    Segond P (1879) Recherches cliniques et expérimentales sur les épanchements sanguins du genou par entorse. Progrés Méd 7:297–299, 319–321, 340–341

  47. 47.

    Sonnery-Cottet B, Archbold P, Rezende FC, Neto AM, Fayard JM, Thaunat M (2014) Arthroscopic identification of the anterolateral ligament of the knee. Arthrosc Tech 3(3):e389–e392

  48. 48.

    Stijak L, Bumbasirevic M, Radonjic V, Kadija M, Puskas L, Milovanovic D, Filipovic B (2014) Anatomic description of the anterolateral ligament of the knee. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-014-3422-6

  49. 49.

    Taneja AK, Miranda FC, Braga CA, Gill CM, Hartmann LG, Santos DC, Rosemberg LA (2014) MRI features of the anterolateral ligament of the knee. Skeletal Radiol. doi:10.1007/s00256-014-2052-x

  50. 50.

    Terry GC, Hughston JC, Norwood LA (1986) The anatomy of the iliopatellar band and iliotibial tract. Am J Sports Med 14(1):39–45

  51. 51.

    Terry GC, LaPrade RF (1996) The biceps femoris muscle complex at the knee. Its anatomy and injury patterns associated with acute anterolateral-anteromedial rotatory instability. Am J Sports Med 24(1):2–8

  52. 52.

    Terry GC, LaPrade RF (1996) The posterolateral aspect of the knee. Anatomy and surgical approach. Am J Sports Med 24(6):732–739

  53. 53.

    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(1):55–60

  54. 54.

    Vieira EL, Vieira EA, da Silva RT, Berlfein PA, Abdalla RJ, Cohen M (2007) An anatomic study of the iliotibial tract. Arthroscopy 23(3):269–274

  55. 55.

    Vincent JP, Magnussen RA, Gezmez F, Uguen A, Jacobi M, Weppe F, Al-Saati MF, Lustig S, Demey G, Servien E, Neyret P (2012) The anterolateral ligament of the human knee: an anatomic and histologic study. Knee Surg Sports Traumatol Arthrosc 20(1):147–152

  56. 56.

    Wahl CJ, Westermann RW, Blaisdell GY, Cizik AM (2012) An association of lateral knee sagittal anatomic factors with non-contact ACL injury: sex or geometry? J Bone Joint Surg Am 94(3):217–226

  57. 57.

    Weber WN, Neumann CH, Barakos JA, Petersen SA, Steinbach LS, Genant HK (1991) Lateral tibial rim (Segond) fractures: MR imaging characteristics. Radiology 180(3):731–734

  58. 58.

    Woods GW, Stanley RF, Tullos HS (1979) Lateral capsular sign: x-ray clue to a significant knee instability. Am J Sports Med 7(1):27–33

  59. 59.

    Wroble RR, Grood ES, Cummings JS, Henderson JM, Noyes FR (1993) The role of the lateral extraarticular restraints in the anterior cruciate ligament-deficient knee. Am J Sports Med 21(2):257–262

  60. 60.

    Zaffagnini S, Marcacci M, Lo Presti M, Giordano G, Iacono F, Neri MP (2006) Prospective and randomized evaluation of ACL reconstruction with three techniques: a clinical and radiographic evaluation at 5 years follow-up. Knee Surg Sports Traumatol Arthrosc 14(11):1060–1069

  61. 61.

    Zaffagnini S, Signorelli C, Lopomo N, Bonanzinga T, Marcheggiani Muccioli GM, Bignozzi S, Visani A, Marcacci M (2012) Anatomic double-bundle and over-the-top single-bundle with additional extra-articular tenodesis: an in vivo quantitative assessment of knee laxity in two different ACL reconstructions. Knee Surg Sports Traumatol Arthrosc 20(1):153–159

  62. 62.

    Zens M, Ruhhammer J, Goldschmidtboeing F, Woias P, Feucht MJ, Mayr HO, Niemeyer P (2014) A new approach to determine ligament strain using polydimethylsiloxane strain gauges: exemplary measurements of the anterolateral ligament. J Biomech Eng 136(12):124504-1–124504-5

Download references

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Correspondence to Daniel Guenther.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Guenther, D., Griffith, C., Lesniak, B. et al. Anterolateral rotatory instability of the knee. Knee Surg Sports Traumatol Arthrosc 23, 2909–2917 (2015). https://doi.org/10.1007/s00167-015-3616-6

Download citation

Keywords

  • Anterolateral capsule
  • Anterolateral ligament
  • Rotatory laxity
  • Rotatory instability
  • Knee