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Anterolateral ligament knee

Sheeba M Joseph, Michael R Karns, Derrick M Knapik, James E Voos
Purpose: To purpose of this study was to compare arthroscopic anterior cruciate ligament (ACL) reconstruction femoral tunnel length measurements from the anterolateral portal between the standard notch view using a 30° arthroscope versus a "top-down" view utilizing a 70° arthroscope to visual the far side of the femoral tunnel aperture. Methods: Arthroscopic femoral tunnel length measurements using calibrated reamers from the standard notch versus the "top-down" view were obtained and reviewed in 54 skeletally mature patients undergoing ACL reconstruction with no prior bony knee surgery...
2018: Frontiers in Surgery
Levi Reina Fernandes, Herve Ouanezar, Adnan Saithna, Bertrand Sonnery-Cottet
The Segond fracture (SF) is considered pathognomonic of an anterior cruciate ligament (ACL) tear. However, the anatomy of the soft-tissue attachments responsible for the avulsion of SFs has been a cause of controversy. A 31-year-old male patient presented with an injury to his right knee that resulted in ACL tear and a SF. Open SF fixation and arthroscopic ACL reconstruction were performed. The anatomical dissection demonstrated that the avulsion of SFs had occurred because of the tibial attachment of the anterolateral ligament (ALL) with an intact Iliotibial band...
March 20, 2018: BMJ Case Reports
Andrew G Geeslin, Jorge Chahla, Gilbert Moatshe, Kyle J Muckenhirn, Bradley M Kruckeberg, Alex W Brady, Ashley Coggins, Grant J Dornan, Alan M Getgood, Jonathan A Godin, Robert F LaPrade
BACKGROUND: The individual kinematic roles of the anterolateral ligament (ALL) and the distal iliotibial band Kaplan fibers in the setting of anterior cruciate ligament (ACL) deficiency require further clarification. This will improve understanding of their potential contribution to residual anterolateral rotational laxity after ACL reconstruction and may influence selection of an anterolateral extra-articular reconstruction technique, which is currently a matter of debate. Hypothesis/Purpose: To compare the role of the ALL and the Kaplan fibers in stabilizing the knee against tibial internal rotation, anterior tibial translation, and the pivot shift in ACL-deficient knees...
March 1, 2018: American Journal of Sports Medicine
Etienne Cavaignac, Gregoire Laumond, Nicolas Reina, Karine Wytrykowski, Jérôme Murgier, Marie Faruch, Philippe Chiron
Ultrasonography (US) is a nonirradiating, low-cost, real-time imaging modality that has very good spatial resolution. US can be used to view the anterolateral ligament (ALL) and injuries to the ALL. Several authors have sought to analyze the anterolateral aspect of the knee using US with varying luck. All of them analyzed the ALL statically only. The goal of this Technical Note is to describe in detail the technique that we use to analyze the anterolateral aspect of the knee in patients with an anterior cruciate ligament tear...
January 2018: Arthroscopy Techniques
Volker Musahl, Elmar Herbst, Jeremy M Burnham, Freddie H Fu
The anterolateral structures of the knee have recently garnered considerable interest regarding their role in rotatory knee instability related to anterior cruciate ligament tears. Isolated anterior cruciate ligament reconstruction may not always restore rotatory stability of the knee. In these patients, additional procedures, such as lateral reconstruction or tenodesis, may be indicated. The anatomy of the anterolateral structures of the knee has been well described. Histologic and anatomic studies have reported conflicting findings regarding the presence of a discrete ligament...
March 6, 2018: Journal of the American Academy of Orthopaedic Surgeons
Yousef Marwan, Shubhang Kulkarni, Abdullah Addar, Nizar Algarni, Iskandar Tamimi, Mathieu Boily, Paul A Martineau
PURPOSE: The purpose of this study is to describe the prevalence and associated factors of anterolateral ligament (ALL) injury in knee dislocation (KD). METHODS: A retrospective review of charts and radiological images was done for patients who underwent multiligamentous knee reconstruction surgery for KD in the authors' institution from May 2008 to December 2016. The inclusion criteria were both genders, skeletally mature, and first dislocation. Previous anterior cruciate ligament injury or surgery were the exclusion criteria...
March 3, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Da-Hui Sun, Yi Zhao, Ji-Ting Zhang, Dong Zhu, Bao-Chang Qi
RATIONALE: It is challenging to visualize and reduce a posterolateral tibial plateau fracture through an anterolateral approach as the tibial plateau fragments are often covered by the fibular head and ligamentous structures. PATIENT CONCERNS: In this case report, we describe a patient with a depression fracture of the posterolateral quadrant combined with a split fracture of the posteromedial quadrant and an avulsion fracture of the tibial intercondylar eminence...
January 2018: Medicine (Baltimore)
Yu-Qing Zeng, Jin-Tao Hu, Jun-Ming Wan, Fu-Hua Zhong, Bin-Feng Jiang, Jian-Fang Zhang, Jian-Wei Lu
Although the function of the anterolateral stabilizing structures of the knee in the anterior cruciate ligament (ACL) injuries has been recognized since many years, most of orthopedic surgeons do not take the anterolateral structure into consideration when performing an ACL reconstruction. Anatomic ACL reconstruction will improve knee stability, but a small subset of patients may experience some residual anteroposterior and rotational instability. For this reason, some researchers have paid attention to the anterolateral aspects of the knee, especially the anterolateral ligament...
August 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Santiago Pache, Zachary S Aman, Mitchell Kennedy, Gilberto Yoshinobu Nakama, Gilbert Moatshe, Connor Ziegler, Robert F LaPrade
The posterior cruciate ligament (PCL) is the largest and strongest ligament in the human knee, and the primary posterior stabilizer. Recent anatomy and biomechanical studies have provided an improved understanding of PCL function. PCL injuries are typically combined with other ligamentous, meniscal and chondral injuries. Stress radiography has become an important and validated objective measure in surgical decision making and post-operative assessment. Isolated grade I or II PCL injuries can usually be treated non-operatively...
January 2018: Archives of Bone and Joint Surgery
Alejandro Espejo-Baena, Alejandro Espejo-Reina, Abel Gómez-Cáceres, Maria Josefa Espejo-Reina, Jaime Dalla Rosa-Nogales
The anterior cruciate ligament (ACL) rupture is a common disease that accounts for 250,000 cases/year in the United States. The anterolateral ligament (ALL) has been suggested to be an important restraint for rotational instability, and its reconstruction provides a reinforcement to the ACL reconstruction in this aspect, especially in high-demand athletes and in knees with high-grade pivot shift. Different techniques for associated ACL and ALL reconstruction have been described, but the ideal technique remains unclear...
October 2017: Arthroscopy Techniques
Seong Hwan Kim, Sang Hak Lee, Kang-Il Kim, Jae Woo Yang
PURPOSE: To document the diagnostic accuracy and steps for sequential arthroscopic exploration of ramp lesions-peripheral tear within 4 mm of meniscocapsular junction of medial meniscus-associated with anterior cruciate ligament (ACL) injury. METHODS: This was a prospective consecutive study of 195 primary ACL reconstructions with arthroscopic exploration for ramp lesion in 4 steps: (1) standard exploration through the anterolateral portal, (2) through the intercondylar space using a 30° arthroscope, (3) through the intercondylar space using a 70° arthroscope, and (4) after creation of a posteromedial portal...
February 2, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Alexander E Weber, William Zuke, Erik N Mayer, Brian Forsythe, Alan Getgood, Nikhil N Verma, Bernard R Bach, Asheesh Bedi, Brian J Cole
BACKGROUND: There has been an increasing interest in lateral-based soft tissue reconstructive techniques as augments to anterior cruciate ligament reconstruction (ACLR). The objective of these procedures is to minimize anterolateral rotational instability of the knee after surgery. Despite the relatively rapid increase in surgical application of these techniques, many clinical questions remain. PURPOSE: To provide a comprehensive update on the current state of these lateral-based augmentation procedures by reviewing the origins of the surgical techniques, the biomechanical data to support their use, and the clinical results to date...
February 1, 2018: American Journal of Sports Medicine
Kevin G Shea, Peter C Cannamela, Peter D Fabricant, Elizabeth B Terhune, John D Polousky, Matthew D Milewski, Allen F Anderson, Theodore J Ganley
PURPOSE: To investigate the relation of the at-risk structures (distal femoral physis, lateral collateral ligament, anterolateral ligament, popliteus, and articular cartilage) during all-epiphyseal femoral tunnel drilling. A second purpose was 2-fold: (1) to develop recommendations for tunnel placement and orientation that anatomically reconstruct the anterior cruciate ligament (ACL) while minimizing the risk of injury to these at-risk structures, and (2) to allow for maximal tunnel length to increase the amount of graft in the socket to facilitate healing...
January 25, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Giuseppe Argento, Mario Vetrano, Lara Cristiano, Tania Suarez, Alessandra Bartoloni, Davide Erroi, Andrea Ferretti, Maria Chiara Vulpiani
Objective: The aim of our study was to determine inter-observer agreement in the ultrasonographic identification of the anterolateral ligament (ALL) and in the evaluation of its length and thickness in healthy subjects. Methods: 80 healthy volunteers (160 knees) (42 males and 38 females) were enrolled in the study. All subjects underwent ultrasound (US) examination of both knees, performed by two physicians with over ten years of musculoskeletal US experience. In order to keep the ALL under optimal tension, the knee was flexed at approximately 30-35°, slightly internally rotated and length and thickness of the ligament were measured...
July 2017: Muscles, Ligaments and Tendons Journal
João Luiz Ellera Gomes, Murilo Anderson Leie, Marcos Marczwski, George Sánchez, Márcio Balbinotti Ferrari
An increasing concern has been given to the rotation stability of the knee in the setting of an anterior cruciate ligament (ACL) reconstruction. This growing interest stems from a better understanding of the rotational stability of the knee afforded by the identification of the anterolateral ligament. Previously, a residual abnormal pivot-shift test had been found after an anatomic single-band reconstruction of the ACL because of a lack of rotational stability, which may lead to the development of osteoarthritis...
October 2017: Arthroscopy Techniques
Assem Mohamed Noureldin Zein, Mohamed Elshafie, Ahmed Nady Saleh Elsaid, Mohamed Ahmed Elsaid Elrefai
The results of arthroscopic anterior cruciate ligament (ACL) reconstruction are so far satisfactory and improving over time as a result of the improved understanding of the anatomy and biomechanics of the ACL. Rotational instability confirmed by a positive pivot shift is present in more than 15% of cases who underwent successful ACL reconstruction. Persistent rotational instability interferes with performing pivoting sports, and also may lead to meniscal and chondral injuries, or re-rupture of the reconstructed ACL...
August 2017: Arthroscopy Techniques
Volkan Kızılgöz, Ali Kemal Sivrioğlu, Hasan Aydın, Türkhun Çetin, Gökhan Ragıp Ulusoy
Objective This study was performed to evaluate the visibility of the knee's anterolateral ligament (ALL) by magnetic resonance (MR) imaging when evaluating injuries of the ALL in relation to injuries of the anterior cruciate ligament (ACL). Methods Two reviewers retrospectively analyzed MR images for the visibility and dimensions of the ALL and the relationship between ALL and ACL injuries. The intraclass correlation coefficient (ICC) and kappa analysis were used to assess interobserver reliability. The chi-square test was used to assess the relationship between ALL and ACL injuries...
January 1, 2018: Journal of International Medical Research
Kara Gaetke-Udager, Corrie M Yablon
Ligamentous structures of the knee are numerous and complex, including the anterior and posterior cruciate ligaments, medial and lateral collateral ligaments, ligaments of the posteromedial and posterolateral corners, and the anterolateral ligament. Clinical assessment after a knee injury is paramount and can direct both the clinician's choice of imaging study and the radiologist's interpretation. Imaging is crucial in that it provides additional information for diagnosis, management, and surgical planning...
February 2018: Journal of Knee Surgery
Yasutaka Tashiro, Ken Okazaki, Koji Murakami, Hirokazu Matsubara, Kanji Osaki, Yukihide Iwamoto, Yasuharu Nakashima
AIM: To quantitatively assess rotatory and anterior-posterior instability in vivo after anterior cruciate ligament (ACL) reconstruction using bone-patellar tendon-bone (BTB) autografts, and to clarify the influence of tunnel positions on the knee stability. METHODS: Single-bundle ACL reconstruction with BTB autograft was performed on 50 patients with a mean age of 28 years using the trans-tibial (TT) ( n = 20) and trans-portal (TP) ( n = 30) techniques. Femoral and tibial tunnel positions were identified from the high-resolution 3D-CT bone models two weeks after surgery...
December 18, 2017: World Journal of Orthopedics
Patrick A Smith
Anterior cruciate ligament (ACL) graft failure rates remain unacceptably high in certain populations, and researchers are examining the effect that the anterolateral ligament (ALL) has on knee stability following ACL reconstruction. Currently, most available research examining the ALL has focused on cadaveric biomechanical kinematic studies, including the effect of surgical techniques for ALL reconstruction/lateral extra-articular tenodesis (LET). However, it is critical for ongoing and future research to focus on clinical outcome measures relating to individuals who have had ALL reconstruction or LET along with their ACL reconstructions...
January 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
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