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INTRODUCTION
Rotational control of the knee is one of the
main objectives of anterior cruciate ligament
reconstruction. The insufficient control in this
area by isolated intra-articular ACL
reconstruction has renewed interest for the
anterolateral compartment of the knee, leading,
one century after P. Segond [10], to the
description of the anterolateral ligament (ALL)
[2]. The interest for this ligament has been
highlighted in several articles regarding its
anatomy, its arthroscopic description, and its
radiological aspect. Nonetheless, its existence
[8], its precise anatomy and its possible
involvement in rotational control and stability
of the knee continue to be debated.
The purpose of this article is to specify the
anatomic description of the ALL based on
recent published studies.
DISSECTION
The dissection technique is a key point of the
anatomic analysis of the ALL: inappropriate
dissection can potentially alter interpretation of
the anatomical characteristics from these
anterolateral structures and consequently their
biomechanical characteristics.
For this dissection, we recommended the
following stages inspired by the works of
S. Claes [2], M. Daggett [3] and a previous
study [7].
After removal of a rectangular flap of skin and
subcutaneous adipose tissue, the extensor
apparatus, the lateral patellar retinaculum, the
superficial layer of the iliotibial tract (ITB), the
distal part of the femoral biceps, and the head
of the fibula are exposed (fig. 1).
ITB is then resected transversally 6cm
proximally from the lateral epicondyle and
pulled back distally by cutting anteriorly the
lateral retinaculum and posteriorly the deep
ANATOMY OF THE
ANTEROLATERAL LIGAMENT
C. LUTZ, B. SONNERY-COTTET, M. DAGGETT, P. IMBERT
Fig 1:
Antero-lateral knee exposure (right knee)