Anatomy of the Anterolateral Ligament of the Knee: A Systematic Review

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dc.contributor Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP LIMA, Diego Ariel de
HELITO, Camilo Partezani FMUSP-HC
LIMA, Lana Lacerda de
SILVA, Daniel de Castro
CAVALCANTE, Maria Luzete Costa
LEITE, Jose Alberto Dias 2019
dc.identifier.citation ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY, v.35, n.2, p.670-681, 2019
dc.identifier.issn 0749-8063
dc.description.abstract Purpose: To conduct a systematic literature review to search for studies on the anatomy of the anterolateral ligament (ALL) of the knee, presenting the most accepted findings, as well as the evolution of anatomic information on this structure. Methods: We reviewed the PubMed, MEDLINE, and ClinicalKey databases for anatomic studies on the ALL, involving cadaveric, histologic, and biochemical dissection and/or anatomic imaging. The primary data researched were the presence of the ligament; measures of length, width, and thickness; ligament path; insertions; number of bands; histologic assessment; and innervation. Results: We identified 53 studies. The ALL was found in 82.87% of adult dissections (more easily visualized in fresh cadavers), 74.07% of fetal dissections, and 84.80% of magnetic resonance imaging (MRI) studies. In 29 articles, the ALL was found in 100% of cases. There are 3 ALL insertion points: femoral, tibial, and meniscal. Histologic sections showed dense, well-organized collagen fibers, with an average of 121 fibroblasts/mm(2) in adults, in addition to the presence of vascular and nervous tissue. MRI was shown to be a good examination tool to visualize the ALL, primarily in the coronal plane and with T2-weighted images. Conclusions: The ALL is a distinct structure in the anterolateral portion of the knee. It exhibits typical ligament characteristics and can be visualized on imaging examinations, especially MRI. It has a femoral attachment near the lateral epicondyle, with a trend in recent years showing it to be located posterior and proximal to it, following an anteroinferior trajectory, with an insertion into the lateral meniscus and proximal tibia at the midpoint between the fibular head and Gerdy tubercle. Among the studies, the length of the ALL varied from 30.41 to 59.0 mm, the width ranged between 4.0 and 7.0 mm, and the thickness ranged between 1.0 and 2.0 mm. Clinical Relevance: During the past few years, much controversy has been raised about the correct anatomy of the ALL. The main clinical relevance of this study is not only to end the discussion about the ALL's existence but also to clarify and synthesize the main evidence on the ALL's anatomy, mainly the currently most accepted attachments according to the recent literature, to enable more precise development of biomechanical settings and surgical techniques.
dc.language.iso eng
dc.relation.ispartof Arthroscopy-The Journal of Arthroscopic and Related Surgery
dc.rights restrictedAccess
dc.subject.other anterior cruciate ligament; magnetic-resonance; radiographic landmarks; segond fracture; femoral origin; length changes; association; prevalence; dissection; insertion
dc.title Anatomy of the Anterolateral Ligament of the Knee: A Systematic Review
dc.type article
dc.rights.holder Copyright W B SAUNDERS CO-ELSEVIER INC LIM/41
dc.identifier.doi 10.1016/j.arthro.2018.09.006
dc.identifier.pmid 30612770
dc.type.category review
dc.type.version publishedVersion HELITO, Camilo Partezani:HC:IOT · LIMA, Diego Ariel de:Fed Univ Rural Semiarid, R Francisco Mota 572, BR-59625900 Mossoro, RN, Brazil
· LIMA, Lana Lacerda de:Univ Estado Rio Grande do Norte, Mossoro, Brazil
· SILVA, Daniel de Castro:Univ Fed Ceara, Dept Cirurgia, Fortaleza, Ceara, Brazil
· CAVALCANTE, Maria Luzete Costa:Univ Fed Ceara, Dept Cirurgia, Fortaleza, Ceara, Brazil
· LEITE, Jose Alberto Dias:Univ Fed Ceara, Dept Cirurgia, Fortaleza, Ceara, Brazil WOS:000457258700067 2-s2.0-85059357621 PHILADELPHIA USA
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dc.description.index MEDLINE
dc.identifier.eissn 1526-3231
hcfmusp.citation.scopus 6
hcfmusp.citation.wos 6 Brasil

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