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Anterolateral And Knee

Malou E Slichter, Nienke Wolterbeek, K Gie Auw Yang, Jacco A C Zijl, Tom M Piscaer
BACKGROUND: Rotational instability of the knee may persist after anterior cruciate ligament (ACL) reconstruction, which may be due to insufficiency of anterolateral stabilizing structures. However, no reliable diagnostic tool or physical examination test is available for identifying patients with anterolateral rotatory instability (ALRI). As shown in cadaveric studies, static internal rotation of the knee is increased in higher flexion angles of the knee after severing the anterolateral structures...
August 9, 2018: Journal of Experimental Orthopaedics
Etienne Cavaignac, Philippe Chiron
Articles on the anterolateral ligament have generated lots of discussion, but a worldwide consensus has been recently reached: the anterolateral ligament exists. Cadaver studies on a small number of subjects should not be used to draw conclusions as they do not replicate real life. We place our faith in clinical studies with a large number of patients as they capture the variability encountered in our practices. This is the true test of a scientific concept.
August 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Justin J Ernat, Joseph W Galvin
A 23-year-old male active duty soldier presented with a biceps femoris tendon snapping over the fibular head with flexion of the knee beyond 90°. Surgical release of anomalous anterolateral tibial and lateral fibular insertions provided relief of snapping with no other repair or reconstruction required. The soldier quickly returned to full running and active duty. Snapping biceps femoris tendon is a rare but potential cause of pain and dysfunction in the lateral knee. The possible anatomical variations and the cause of snapping must be considered when determining the operative approaches to this condition...
July 2018: American Journal of Orthopedics
Alan Getgood, Charles Brown, Timothy Lording, Andrew Amis, Steven Claes, Andrew Geeslin, Volker Musahl
The structure and function of the anterolateral complex (ALC) of the knee has created much controversy since the 're-discovery' of the anterolateral ligament (ALL) and its proposed role in aiding control of anterolateral rotatory laxity in the anterior cruciate ligament (ACL) injured knee. A group of surgeons and researchers prominent in the field gathered to produce consensus as to the anatomy and biomechanical properties of the ALC. The evidence for and against utilisation of ALC reconstruction was also discussed, generating a number of consensus statements by following a modified Delphi process...
July 25, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Sandra Kolaczek, Christopher Hewison, Scott Caterine, Rebecca Berardelli, Tyler Beveridge, Ben Herman, Mark Hurtig, Karen Gordon, Alan Getgood
PURPOSE: Injury or degeneration of the meniscus has been associated with the development of osteoarthritis of the knee joint. Meniscal allograft transplant (MAT) has been shown to reduce pain and restore function in patients who remain symptomatic following meniscectomy. The purpose of this study is to evaluate and compare the three-dimensional (3D) strain in native medial menisci compared to allograft-transplanted medial menisci in both the loaded and unloaded states. METHODS: Ten human cadaveric knees underwent medial MAT, utilizing soft-tissue anterior and posterior root fixation via transosseous sutures tied over an anterolateral proximal tibial cortical bone bridge...
July 24, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Richard N Puzzitiello, Avinesh Agarwalla, William A Zuke, Grant H Garcia, Brian Forsythe
PURPOSE: The purpose of this study is to systematically review the literature to evaluate the reliability, or the ability of a repeated measurement to yield consistent results, and validity of ultrasound (US) and magnetic resonance imaging (MRI) at evaluating anatomy and pathology of the anterolateral ligament of the knee (ALL) in the setting of anterior cruciate ligament (ACL) injuries. Furthermore, the incidence and association of ALL injury with the pivot-shift examination, and other structural injuries, will be reviewed for additional clinical relevance...
July 20, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Thomas Neri, David Anthony Parker, Aaron Beach, Bertrand Boyer, Frederic Farizon, Remi Philippot
To better control anterolateral rotational instability (ALRI) after anterior cruciate ligament reconstruction (ACLR), many recent studies have examined the anterolateral ligament (ALL). Although some inconsistencies have been reported, anatomic studies demonstrated that the ALL runs on the lateral side of the knee from the femoral lateral epicondyle area to the proximal tibia, between Gerdy's tubercle and the fibula head. Histologic research has characterized the ALL structure, which is more than a simple capsular thickening; it shows a dense collagen core, typical bony insertions and mechanoreceptor function...
July 5, 2018: Surgical Technology International
Sachiyuki Tsukada, Kenji Kurosaka, Masahiro Nishino, Naoyuki Hirasawa
BACKGROUND: Anterolateral skin incision can preserve the skin sensory of the anterior aspect of the knee and may improve kneeling ability after total knee arthroplasty (TKA). METHODS: This is a prospective, 2-arm, parallel-group, randomized, controlled trial involving patients scheduled for TKA. A total of 118 patients (162 knees) were randomly assigned to receive anterolateral skin incision or anteromedial skin incision with 1:1 treatment allocation. The surgical techniques other than skin incision were identical in both groups...
June 19, 2018: Journal of Arthroplasty
Etienne Cavaignac
Perspectives on the anterolateral ligament have changed greatly since the first articles were published that cast doubt on the existence of this structure. The current debate is centered on how to best analyze it. Surgeons are increasingly focusing on the knee's secondary restraints. It is important to understand that magnetic resonance imaging is not the only imaging modality available to us.
July 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Evgeniy Nikolaevich Goncharov, Oleg Aleksandrovich Koval, Eduard Nikolaevich Bezuglov, Nikolay Gavriilovich Goncharov
BACKGROUND: The anterolateral ligament (ALL) was discovered in 1879. For over 130 years, this anatomical structure did not enjoy much attention, but the situation started to change when a number of researchers described its contribution to the rotational stability of the knee joint. PURPOSE OF THE STUDY: To estimate the occurrence of the ALL and describe the aspects of its anatomy that should be factored into the outcome of stabilizing surgeries of the knee joint...
July 3, 2018: International Orthopaedics
Hiroko Ueki, Yusuke Nakagawa, Toshiyuki Ohara, Toshifumi Watanabe, Masafumi Horie, Hiroki Katagiri, Koji Otabe, Kenta Katagiri, Kanehiro Hiyama, Mai Katakura, Takashi Hoshino, Kei Inomata, Naoko Araya, Ichiro Sekiya, Takeshi Muneta, Hideyuki Koga
PURPOSE: To investigate the risk factors for residual pivot shift test after anterior cruciate ligament (ACL) reconstruction based on a multicenter prospective cohort study. METHODS: This study included patients who were registered in the Multicenter Arthroscopic Knee Surgery Study, a prospective longitudinal multicenter cohort study, and who underwent primary ACL reconstruction using autologous hamstring tendon graft between 2013 and 2016. The exclusion criteria included prior injuries or surgeries in the contralateral knee, prior ligamentous injuries in the involved knee, grade 2 or 3 concomitant ligament injuries, and inflammatory or other forms of osteoarthritis...
June 8, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Rogério Teixeira de Carvalho, Carlos Eduardo Franciozi, Yasuo Itami, Michelle H McGarry, Sheila Jean McNeill Ingham, Rene Jorge Abdalla, James Eugene Tibone, Thay Q Lee
PURPOSE: Understanding the pathomechanics of a bicruciate injury (BI) is critical for its correct diagnosis and treatment. The purpose of this biomechanical study aims to quantify the effects of sequential sectioning of the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) bundles on knee laxity. METHODS: Twelve cadaveric knees (six matched pairs) were used. Knee laxity measurements consisted of neutral tibial position, anterior-posterior translation, internal-external rotation, and varus-valgus angulation in different conditions: intact, ACL cut, incomplete BI (divided into two groups: anterolateral (AL) bundle intact or posteromedial (PM) bundle intact) and complete bicruciate tear...
June 8, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Michael T Cibulka, Jack Bennett
Anterior cruciate ligament (ACL) injuries are common in sports including a significant failure rate following reconstruction. The iliotibial band (ITB) is an important stabilizer of the lateral portion of the knee and also an important lateral rotator of the tibia. Both the tensor fascia lata (TFL) and gluteus maximus (Gmax) muscles insert into the ITB proximally. This paper describes a theory that implicates weakened TFL and Gmax muscles as possible contributors to anterolateral rotatory instability. If the TFL and Gmax are important contributors to anterolateral rotatory instability, physical therapists can emphasize assessing for their weakness and developing a rehabilitation program to restore their strength...
June 21, 2018: Physiotherapy Theory and Practice
Ezio Adriani, Berardino Di Paola, Andrea Alfieri, Edoardo De Fenu
Posterior cruciate ligament (PCL) ruptures account for 1% to 44% of all acute ligament injuries of the knee. In this paper we wanted to try out a system for femural fixation. Hamstring tendons are harvested and standard tibial tunnel is prepared using the transtibial PCL guide; by identifying the PCL footprint, the femoral half tunnel 27 to 30 mm with in-out technique is performed. The femoral rod of a curve cross-pin system is inserted into the anterolateral access within the femoral half tunnel. The guide block is placed 2...
April 2018: Arthroscopy Techniques
Marcello Zappia, Francesco Oliva, Vito Chianca, Francesco Di Pietto, Nicola Maffulli
Rotational stability of the knee involves not only the cruciate ligaments but also another structure named anterolateral ligament (ALL), the function of which is still controversial. This study evaluated the effectiveness of high-resolution ultrasound (US) examination to detect the ALL. We studied 8 cadaveric knees (8 ALLs). On each knee, high-resolution real-time ultrasonography examination was performed by an experienced musculoskeletal radiologist before and after the procedure, with the surgeons blind to the results of the scan both before and after dissection...
May 31, 2018: Journal of Knee Surgery
Jiangyu Cai, Wenhe Jin, Dandan Sheng, Shiyi Chen
Objective: To make further exploration of the structure characteristics of anterolateral ligament (ALL) and provide clinical reference for diagnosis and treatment of ALL injury, especially for ALL reconstruction through anatomical study of ALL in a Chinese population. Methods: Sixteen cadaveric knees, including 8 left knees and 8 right knees with sex ratio of 1∶1 and a mean age of 73.5 years (range, 57-84 years), were dissected to reveal the ALL through a standard approach...
December 1, 2017: Chinese Journal of Reparative and Reconstructive Surgery
Shimin Zhang, Sunjun Hu, Shouchao Du, Zhuo Ma
Objective: To summarize the progress in the treatment of hyperextension tibial plateau fractures. Methods: Related literature concerning hyperextension tibial plateau fractures was reviewed and analyzed in terms of injury mechanisms, clinical patterns, and treatment outcomes. Results: Hyperextension tibial plateau fractures is a specific type of hyperextension knee injuries, which is happened with the knee in over-extended position (<0°) and characterized by fracture and concomitant ligament injury...
April 1, 2018: Chinese Journal of Reparative and Reconstructive Surgery
Mitchell I Kennedy, Robert F LaPrade
Anterolateral ligament injuries with knee dislocations appear to be very common. In particular, those that occur with fibular (lateral) collateral ligament injuries are very frequent. Although the majority of injuries in this magnetic resonance imaging study appear to be at the proximal attachment of the anterolateral ligament, caution is advised because there is still no clear agreement as to the anatomic attachment site of the anterolateral ligament on the femur. Distal-based anterolateral ligament injuries, either bony or soft tissue Segond variants, have a large consensus in the peer-reviewed literature as to their anatomic attachment sites and injury pattern identification...
June 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
M D Liu, X K Yang, F Han, Z Q Fang, Y Zhang, D H Hu, K Tao
Objective: Strategy for wound repair of skin and soft tissue defect and systematic rehabilitation treatment for functional reconstruction of patients with severe burn or trauma on knees. Methods: From January 2015 to October 2016, 26 patients with skin and soft tissue defect on knees after severe burn or trauma were hospitalized in our unit. Among these patients, 14 patients had patellar ligament defect, and 16 patients had knee joint capsule defect. Wound debridement was operated on 1 to 3 days after admission...
May 20, 2018: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
Hua Zhang, Man Qiu, Zhongwei Xu, Weilin Wang, Shiyang Chen, Jian Zhang, Aiguo Zhou, Kaihui Lu, Michael Huo, Dianming Jiang
The anterolateral ligament, a distinct structure connecting the lateral femoral epicondyle to the anterolateral proximal tibia, is gaining attention because of its possible function in ensuring internal rotational stability of the tibia. To study the prevalence and precise anatomical characteristics of the anterolateral ligament and its relationship to adjacent structures in a Chinese population, a total of 20 amputated knee specimens were collected. The anterolateral regions of the knees underwent detailed surgical dissection, followed by precise measurement of the anterolateral ligament and its adjacent structures...
August 2018: Journal of Anatomy
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