Anterolateral ligament

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The anterolateral ligament (ALL) ( lat.ligamentum anterolaterale ) is a ligament on the outside of the human knee , between the thighbone and the shinbone . The ligament arises next to the outer ligament on the lateral epicondyle of the thigh bone, with some fibers emerging from the proximal attachment of the outer ligament. It is connected to the outer meniscus , but the arteria and vena genicularis inferior externa usually run through between the outer meniscus and ALL. The ligament then runs obliquely downwards and becomes wider and starts at the surface of the tibial head that is directed to the front and outside ( anterolateral ). There is a small depression (recessus tibialis lateralis), which lies clearly behind the tuberculum Gerdy , the insertion of the tractus iliotibialis .

The meaning and independence of the tape have long been controversial. It is supposed to stabilize the knee joint laterally; a tear of the ligament together with the anterior cruciate ligament could be a cause of the pivot-shift phenomenon . It is a powerful knee stabilizer against internal rotation, especially at 30 ° -90 ° knee flexion.

The surgeons Steven Claes and Johan Belleman from the Belgian University of Leuven published the discovery of the tape in the journal "Journal of Anatomy" in August 2013. In a retrospective examination of 351 magnetic resonance tomographies of knee joints in which an anterior cruciate ligament rupture had been surgically treated, the Belgian working group found ALL in 206 knees (76%), although it is difficult to visualize in the usual magnetic resonance tomography sections due to the oblique shape. Of these, 44 ligaments were unharmed (21%) and 162 ligaments (79%) were torn. In the majority of cases the tear was located at the distal end (78%), only in 20% proximally. And the bony avulsion fracture known as Segond's fracture was only found in three knees (2%) .

The French surgeon Paul Ferdinand Segond already described the tape in 1879 as a "mother-of-pearl-colored, resistant, fibrous tape"; the bony avulsion fracture of the tape is named after him the Segond fracture . The Swiss knee surgeon Werner Müller also described the ligament as the "Lig. Femorotibiale anterius" in the manual "Das Knie" in 1982.

Individual evidence

  1. ↑ Steven Claes, Evie Vereecke et al. a .: Anatomy of the anterolateral ligament of the knee. In: Journal of Anatomy. 223, 2013, pp. 321-328, doi : 10.1111 / joa.12087 .
  2. ↑ Steven Claes, Stijn Bartholomeeusen, Johan Bellemans: High prevalence of anterolateral Ligament abnormalities in magnetic resonance images of anterior cruciate ligament-injured knees Acta Orthopædica Belgica 2014, Volume 80, Issue 1 of March 2014, pp. 45-49
  3. ↑ Werner Müller: The knee: Form, function and ligamentous reconstructive surgery p. 47, 1982

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