Abstract
BackgroundIt has been suggested that the anterolateral ligament (ALL) is an important anterolateral stabilizer of the knee joint which functions to prevent anterolateral subluxation and anterior subluxation at certain flexion angles in the knee.PurposeTo analyze and systematically interpret the biomechanical function of the ALL.MethodsAn online search was conducted for human cadaveric biomechanical studies that tested function of the ALL in resisting anterolateral subluxation and anterior subluxation of the knee. Two reviewers independently searched Medline, Embase, and the Cochrane Database of Systematic Reviews for studies up to 25 September 2018. Biomechanical studies not reporting the magnitude of anterior tibial translation or tibial internal rotation in relation to the function of the ALL were excluded.ResultsTwelve biomechanical studies using human cadavers evaluating parameters including anterior tibial translation and/or internal tibial rotation in anterior cruciate ligament (ACL)-sectioned and ALL-sectioned knees were included in the review. Five studies reported a minor increase or no significant increase in anterior tibial translation and internal tibial rotation with further sectioning of the ALL in ACL-deficient knees. Five studies reported a significant increase in knee laxity in tibial internal rotation or pivot shift with addition of sectioning the ALL in ACL-deficient knees. Two studies reported a significant increase in both anterior tibial translation and internal tibial rotation during application of the anterior-drawer and pivot-shift tests after ALL sectioning.ConclusionThere was inconsistency in the biomechanical characteristics of the ALL of the knee in resisting anterolateral and anterior subluxation of the tibia.
Highlights
The existence of a specific structure in the knee’s lateral capsule was discovered by dissections performed in 1879 by Paul Segond
Given the relative paucity of literature reviewing the native biomechanics of the anterolateral ligament (ALL) of the knee, the purpose of the present study was to provide a systematic review of the biomechanical ALL function excluding the surgical aspect of anterior cruciate ligament (ACL) and/or ALL
Review of the titles and abstracts excluded 76 duplicates as well as 149 studies not related to biomechanical study of the ALL of the knee
Summary
The existence of a specific structure in the knee’s lateral capsule was discovered by dissections performed in 1879 by Paul Segond. The ALL has been the subject of many recent publications there has Despite recent improvements in surgical methods and understanding of ACL anatomy, it has been suggested that the normal rotational stability of the knee is not fully restored by reconstructive methods for ACL injuries [5, 6]. Such abnormal biomechanics have led surgeons to focus more on anterolateral structures and, in the past few years, the ALL of the knee has been studied with regard to its anatomy and biomechanics [3, 7–9]. It has been suggested that the anterolateral ligament (ALL) is an important anterolateral stabilizer of the knee joint which functions to prevent anterolateral subluxation and anterior subluxation at certain flexion angles in the knee.
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