Anterolateral ligament

The anterolateral ligament (ALL) is a ligament on the lateral aspect of the human knee, anterior to the fibular collateral ligament.[1]

Anterolateral ligament
FromLateral epicondyle of the femur
ToAnterolateral aspect of the proximal tibia
Anatomical terminology

Perhaps the earliest account of the ALL was written by French surgeon Paul Segond in 1879, in which he described a ligamentous structure between the lateral femur and tibia.[2][3]

Claes and Bellemans (2013) found that the ALL originates at the lateral epicondyle of the femur, and inserts at the anterolateral aspect of the proximal tibia.[1] However, Vincent et al. (2012) reported the origin to be the lateral femoral condyle.[4]

Clinical relevance

The ALL, which has been suggested to occur in 33-97% of the human population,[1][4][5] seems to stabilize medial rotation of the knee.[1] However, the anterior cruciate ligament is the most important contributor to rotatory knee stability. It is uncertain if an isolated anterolateral ligament injury with an intact anterior cruciate ligament injury leads to knee instability. This topic is being hotly debated and researched. The "pivot shift" phenomenon in anterior cruciate ligament injury patients may be ascribed to additional trauma to the ALL[1] or other structures in the anterolateral knee.

The Segond fracture is probably an avulsion of the anterolateral ligament.[6] In such injuries, fragments of the lateral tibial condyle of the knee are torn from the bone by the soft tissue structures of the anterolateral knee.


The ALL can be visualised in most patients on MRI with its attachments to the lateral meniscus body and further tibial insertion on the coronal sequences.

References
  1. Claes, S.; Vereecke, E.; Maes, M.; Victor, J.; Verdonk, P.; Bellemans, J. (Oct 2013). "Anatomy of the anterolateral ligament of the knee". J Anat. 223 (4): 321–8. doi:10.1111/joa.12087. PMC 3791125. PMID 23906341.
  2. Segond P (1879) Recherches cliniques et expérimentales sur les épanchements sanguins du genou par entorse. Progrès Médical (Paris) (accessible from Archived 2012-12-31 at the Wayback Machine), 1-85.
  3. Recherches cliniques et expérimentales sur les épanchements sanguins du genou par entorse, par Paul Segond. 1879. Retrieved November 6, 2013.
  4. Vincent, J. P.; Magnussen, R. A.; Gezmez, F.; et al. (January 2012). "The anterolateral ligament of the human knee: An anatomic and histologic study". Knee Surg Sports Traumatol Arthrosc. 20 (1): 147–52. doi:10.1007/s00167-011-1580-3. PMID 21717216.
  5. Hughston, JC; Andrews, JR; Cross, MJ; Moschi, A (1976). "Classification of knee ligament instabilities. Part II. The lateral compartment". J Bone Joint Surg Am. 58 (2): 173–9. doi:10.2106/00004623-197658020-00002. PMID 1254620.
  6. Shaikh, Humza; Herbst, Elmar; Rahnemai-Azar, Ata Amir; Bottene Villa Albers, Marcio; Naendrup, Jan-Hendrik; Musahl, Volker; Irrgang, James J.; Fu, Freddie H. (August 2017). "The Segond Fracture Is an Avulsion of the Anterolateral Complex". The American Journal of Sports Medicine. 45 (10): 2247–2252. doi:10.1177/0363546517704845. ISSN 1552-3365. PMID 28499093.
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