The Normal Anterolateral Ligament of the Knee according to Ultrasound Examination
ARTICLE PDF (Українська)

Keywords

anterolateral ligament
ultrasonography
knee
thickness
Segond fracture

How to Cite

Kostrub, O., КotiukV., Luchko, R., Blonskyi, R., Vadziuk, N., & Didukh, P. (2022). The Normal Anterolateral Ligament of the Knee according to Ultrasound Examination. TERRA ORTHOPAEDICA, (1(112), 32-37. https://doi.org/10.37647/0132-2486-2022-112-1-32-37

Abstract

Summary. Relevance. Ultrasonographic parameters of the anterolateral ligament (ALL), a recently described anatomical structure, are essential to have a starting point in its injury diagnostics.

Objective: to determine the ultrasonographic parameters of the normal ALL.

Materials and Methods. We studied 47 volunteers (94 joints) without a history of injuries of the knee joints with a multi-frequency linear sensor Philips HD-11 XE #USD0874946.

Results. The ALL was visualized in all 94 knee joints. The ALL looked like an anisotropic fibrillar structure and seemed to be symmetrical in 93.62% of patients. We were able to assess the integrity of the ALL in only 82.98% of the knee joints. The minimum thickness of the ALL was always in its meniscal part (1.43±0.54 mm). The thickest part was the area of attachment to the tibia (3.26±0.47 mm); the width of the tibial ALL attachment was 12.83±2.64 mm. The thickness of the ALL femoral attachment was difficult to estimate in most cases due to the braiding of the ALL and fibular collateral ligament fibers together. We could visualize the tibial and meniscal portion in 100%, femoral – in 95.74%, and menisco-tibial – in only 4.26%. There is a violation of the cortical layer integrity at the site of the tibial ALL attachment in at least one knee joint in 25.53% of patients without a history of injuries.

Conclusions. The contralateral knee joint ALL may be a valid reference for ultrasonographic comparison for the injured ALL. Ultrasonographic signs of the cortical layer discontinuity at the tibial ALL attachment are not indisputable symptoms of Segond fracture.

https://doi.org/10.37647/0132-2486-2022-112-1-32-37
ARTICLE PDF (Українська)

References

Bottoni CR, Liddell TR, Trainor TJ, Freccero DM, Lindell KK. Postoperative range of motion following anterior cruciate ligament reconstruction using autograft hamstrings: a prospective, randomized clinical trial of early versus delayed reconstructions. Am J Sports Med. 2008;36(4):656–62. DOI: 10.1177/0363546507312164.

Ardern CL, Webster KE, Taylor NF, Feller JA. Return to the preinjury level of competitive sport after anterior cruciate ligament reconstruction surgery: two-thirds of patients have not returned by 12 months after surgery. Am J Sports Med. 2011 Mar; 39(3):538-43. DOI: 10.1177/2F0363546510384798.

Chouliaras V, Ristanis S, Moraiti C, Tzimas V, Stergiou N, Georgoulis AD. Anterior cruciate ligament reconstruction with a quadrupled hamstrings tendon autograft does not restore tibial rotation to normative levels during landing from a jump and subsequent pivoting. J Sports Med Phys Fitness. 2009;49(1):64-70.

Stergiou N, Ristanis S, Moraiti C, Georgoulis AD. Tibial rotation in anterior cruciate ligament (ACL) – deficient and ACL-reconstructed knees: A theoretical proposition for the development of osteoarthritis. Sports Med. 2007;37(7):601-613. DOI: 10.2165/00007256-200737070-00004.

Bonasia DE, D’Amelio A, Pellegrino P, Rosso F, Rossi R. Anterolateral Ligament of the Knee: Back to the Future in Anterior Cruciate Ligament Reconstruction. Orthop Rev (Pavia). 2015;7(2):5773. DOI: 10.4081/or.2015.5773.

Faruch BM, Cavaignac E, Wytrykowski K, Constans O, Lapègue F, Chiavassa GH, Larbi A, Sans N. Anterolateral ligament injuries in knees with an anterior cruciate ligament tear: contribution of ultrasonography and MRI. Eur Radiol 2018; 28: 58–65. DOI: 10.1007/s00330-017-4955-0.

Ferretti A, Monaco E, Vadalà A. Rotatory instability of the knee after ACL tear and reconstruction. J Orthop Traumatol. 2014;15(2):75-79. DOI: 10.1007/s10195-013-0254-y.

Claes S, Vereecke E, Maes M, Victor J, Verdonk P, Bellemans J. Anatomy of the anterolateral ligament of the knee. J Anat. 2013;223(4):321-328. DOI: 10.1111/joa.12087.

Helito CP, Helito PV, Costa HP, Bordalo-Rodrigues M, Pecora JR, Camanho GL, Demange MK. MRI evaluation of the anterolateral ligament of the knee: assessment in routine 1.5-T scans. Skeletal Radiol. 2014;43(10):1421-7. DOI: 10.1007/s00256-014-1966-7.

Van Dyck P, De Smet E, Lambrecht V, Heusdens CH, Van Glabbeek F, Vanhoenacker FM, Gielen JL, Parizel PM. The Anterolateral Ligament of the Knee: What the Radiologist Needs to Know. Semin Musculoskelet Radiol. 2016;20(1):26-32. DOI: 10.1055/s-0036-1579679.

Oshima T, Nakase J, Numata H, Takata Y, Tsuchiya H. Ultrasonography imaging of the anterolateral ligament using realtime virtual sonography. Knee. 2016;23(2):198–202. DOI: 10.1016/j.knee.2015.10.002.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.