The Cadaveric Studies and the Definition of the Antero-Lateral Ligament of the Knee: From the Anatomical Features to the Patient-Specific Reconstruction Surgical Techniques.

Giacomo Dal Fabbro,Nicolò Maitan,Gian Andrea Lucidi,Stefano Zaffagnini,Piero Agostinone,Alberto Grassi,Nicola Pizza

doi:10.3390/ijerph182312852

Abstract

Cadaver studies represented a milestone in surgical orthopaedic research, and still today they play a crucial role in the achievement of new knowledge about joint disease behaviour and treatment. In this review, an overview of the cadaver studies available in the literature about the anatomy, role, and treatment of the antero-lateral ligament (ALL) of the knee was performed. The aim of the review was to describe and gain more insight into the part of in vitro study in understanding knee joint anatomy and biomechanics, and in developing surgical reconstruction techniques. The findings of the review showed that cadaver studies had, and will continue to have, a key role in the research of knee joint biomechanics and surgical reconstruction. Moreover, they represent a powerful tool to develop and test new devices which could be useful in clinical and surgical practice.

Highlights

A deep knowledge of human anatomy is mandatory for surgeons, and the possibility of directly studying human corpses surely improves the training of all the medical students
The aim of the present study is to perform a narrative review of the in vitro studies involved in the anatomical description, biomechanical analysis of the role and the effect of different lateral extra-articular tenodesis (LET) procedures on the knee joint behaviour, and to demonstrate how the cadaveric investigations have an essential role in developing new surgical knowledge and techniques, possibly targeted to specific patients
The research was performed for anatomical and biomechanical human cadaveric studies regarding the feature of the antero-lateral ligament (ALL) of the knee, the effect of its rupture and the in vitro biomechanical results of the reconstruction technique in the setting of anterior cruciate ligament (ACL)-injured and ACL-reconstructed knee

Summary

Introduction

A deep knowledge of human anatomy is mandatory for surgeons, and the possibility of directly studying human corpses surely improves the training of all the medical students. The orthopaedic surgical techniques have improved in leaps and bounds in recent decades, we are still far from the possibility of completely restoring injured anatomical structures. In this regard, one of the most debated topics in knee surgery is the necessity to improve anterior cruciate ligament (ACL) reconstructions because the standards of treatment of this kind of injury, one of the most common among athletes, and common people [2], is far from being considered perfect. One of the main problems in this sense is the presence of residual rotatory instability after ACL reconstruction, an event that severely affected sportive people, and could explain the higher rate of osteoarthritis among people who underwent this type of surgery [3]

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