A cadaveric study of the anterolateral ligament: re-introducing the lateral capsular ligament.

Authors

Scott Caterine, Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St, London, ON, N6A 3K7, Canada & Fowler Kennedy Sport Medicine Clinic, 3M Centre, Western University, 1151 Richmond St, London, ON, N6A 3K7, Canada
Robert Litchfield, Fowler Kennedy Sport Medicine Clinic, 3M Centre, Western University, 1151 Richmond St, London, ON, N6A 3K7, Canada
Marjorie Johnson, Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St, London, ON, N6A 3K7, Canada
Blaine Chronik, Department of Physics and Astronomy, Western University, 1151 Richmond St, London, ON, N6A 3K7, Canada
Alan Getgood, Fowler Kennedy Sport Medicine Clinic, 3M Centre, Western University, 1151 Richmond St, London, ON, N6A 3K7, CanadaFollow

Document Type

Article

Publication Date

11-1-2015

Journal

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA

Volume

23

Issue

11

First Page

3186

Last Page

3195

URL with Digital Object Identifier

10.1007/s00167-014-3117-z

Abstract

PURPOSE: The purpose of this study was to verify and characterize the anatomical properties of the anterolateral capsule, with the aim of establishing a more accurate anatomical description of the anterolateral ligament (ALL). Furthermore, microscopic analysis of the tissue was performed to determine whether the ALL can morphologically be classified as ligamentous tissue, as well as reveal any potential functional characteristics.

METHODS: Three different modalities were used to validate the existence of the ALL: magnetic resonance imagining (MRI), anatomical dissection, and histological analysis. Ten fresh-frozen cadaveric knee specimens underwent MRI, followed by anatomical dissection which allowed comparison of MRI to gross anatomy. Nine additional fresh-frozen cadaveric knees (19 total) were dissected for a further anatomical description. Four specimens underwent H&E staining to look at morphological characteristics, and one specimen was analysed using immunohistochemistry to locate peripheral nervous innervation.

RESULTS: The ALL was found in all ten knees undergoing MRI and all nineteen knees undergoing anatomical dissection, with MRI being able to predict its corresponding anatomical dissection. The ALL was found to have bone-to-bone attachment points from the lateral femoral epicondyle to the lateral tibia, in addition to a prominent meniscal attachment. Histological sectioning showed ALL morphology to be characteristic of ligamentous tissue, having dense, regularly organized collagenous bundles. Immunohistochemistry revealed a large network of peripheral nervous innervation, indicating a potential proprioceptive role.

CONCLUSION: From this study, the ALL is an independent structure in the anterolateral compartment of the knee and may serve a proprioceptive role in knee mechanics.