Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 25, Issue 4, pp 1055–1061 | Cite as

Kinematics of ACL and anterolateral ligament. Part I: Combined lesion

  • T. BonanzingaEmail author
  • C. Signorelli
  • A. Grassi
  • N. Lopomo
  • L. Bragonzoni
  • S. Zaffagnini
  • M. Marcacci



To quantify the influence of ALL lesions on static and dynamic laxity in ACL-deficient knee.


The study was performed in 10 fresh-frozen knees. The joints were analysed in the following conditions: intact, ACL resection and ACL + ALL resection. Testing parameters were defined as: anterior displacement at 30° and 90° of flexion (AP30, AP90) applying a manual-maximum load; internal rotation at 30° and 90° of flexion (INT30, INT90) applying a 5 N m torque and internal rotation and acceleration during manual pivot-shift (PS) test. Kinematics was acquired by a navigation system; a testing rig and a torquemeter were used to control the limb position and the applied torque. Paired Student’s t test was conducted to assess statistical difference, and significance was set at P < 0.05.


The ALL resection determined a significant increase in terms of internal rotation (INT30 P = 0.02, INT90 P = 0.03), while AP30 (P n.s) and AP90 (P n.s) were not affected. ALL resection produced a significant increase in terms of acceleration during PS test (P < 0.01), but no significant change in PS internal rotation was observed.


The ALL plays a significant role in controlling static internal rotation and acceleration during PS test. On the other hand, ALL resection did not produce any significant change in terms of anterior displacement. A trend was seen for the internal rotation during the pivot-shift test to increase after ALL resection was higher when compared to the intact and isolated ACL lesion states; however, the differences were not significant. The results highlight the clinical relevance of this structure that should be assessed before an ACL reconstruction in order to avoid residual laxity.


Anterolateral Laxity Navigation system Combined lesions 



This work was supported by Italian Ministry of Health, Progetto RF Ministero Salute [grant number 2010-2312173].

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


This work was supported by Italian Ministry of Health, Progetto RF Ministero Salute [grant number 2010-2312173].

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.


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Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2016

Authors and Affiliations

  • T. Bonanzinga
    • 1
    • 2
    Email author
  • C. Signorelli
    • 1
  • A. Grassi
    • 1
    • 2
  • N. Lopomo
    • 1
    • 3
  • L. Bragonzoni
    • 1
    • 4
  • S. Zaffagnini
    • 1
    • 2
    • 4
  • M. Marcacci
    • 1
    • 2
    • 4
  1. 1.Laboratorio di Biomeccanica e Innovazione TecnologicaIstituto Ortopedico RizzoliBolognaItaly
  2. 2.Clinica Ortopedica e Traumatologica IIstituto Ortopedico RizzoliBolognaItaly
  3. 3.Dipartimento di Ingegneria dell’InformazioneUniversità degli Studi di BresciaBresciaItaly
  4. 4.Dipartimento di Scienze Biomediche e NeuromotorieUniversità di BolognaBolognaItaly

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