Anatomic dissection of the anterolateral ligament (ALL) in paired fresh-frozen cadaveric knee joints

Introduction Different dissection studies as well as comparative studies about the anterolateral ligament of the knee (ALL) already exist and the structure’s topology and properties have been shown. However, most of the studies investigating the ligament were performed in embalmed knees, which is th...

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Veröffentlicht in:Archives of orthopaedic and trauma surgery 2017-02, Vol.137 (2), p.249-255
Hauptverfasser: Roessler, Philip P., Schüttler, Karl F., Stein, Thomas, Gravius, Sascha, Heyse, Thomas J., Prescher, Andreas, Wirtz, Dieter C., Efe, Turgay
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container_end_page 255
container_issue 2
container_start_page 249
container_title Archives of orthopaedic and trauma surgery
container_volume 137
creator Roessler, Philip P.
Schüttler, Karl F.
Stein, Thomas
Gravius, Sascha
Heyse, Thomas J.
Prescher, Andreas
Wirtz, Dieter C.
Efe, Turgay
description Introduction Different dissection studies as well as comparative studies about the anterolateral ligament of the knee (ALL) already exist and the structure’s topology and properties have been shown. However, most of the studies investigating the ligament were performed in embalmed knees, which is thought to change the structural integrity of ligaments and thus the topologic and dynamic measurements. Since the biomechanical function of the ALL is not fully understood until today and a correlation with the pivot shift phenomenon is yet speculative, further studies will have to clarify its definitive importance. Its function as a limiter of internal rotation and lateral meniscal extrusion leads to the assumption of a secondary knee stabilizer. Methods Twenty paired fresh-frozen cadaveric knees of ten donors have been dissected in a layerwise fashion. After identification of the ALL, topologic measurements were undertaken using a digital caliper. Results The ALL could be identified as a tender, pearly structure in front of the anterolateral joint capsule in only 60% of the dissected knee joints. Only 20% of donors had a bilateral ALL while 80% had an ALL only in one side. Mean length, thickness and width as well as topographic measurements were comparable to other available studies investigating fresh-frozen cadavers. Conclusion Anatomy and topography of the ALL seem to be highly variable, but consistent within certain borders. Prevalence has to be argued though as it strongly differs between studies. The impact of an ALL absence, even if only unilateral, needs to be investigated in clinical and imaging studies to finally clarify its importance.
doi_str_mv 10.1007/s00402-016-2617-3
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However, most of the studies investigating the ligament were performed in embalmed knees, which is thought to change the structural integrity of ligaments and thus the topologic and dynamic measurements. Since the biomechanical function of the ALL is not fully understood until today and a correlation with the pivot shift phenomenon is yet speculative, further studies will have to clarify its definitive importance. Its function as a limiter of internal rotation and lateral meniscal extrusion leads to the assumption of a secondary knee stabilizer. Methods Twenty paired fresh-frozen cadaveric knees of ten donors have been dissected in a layerwise fashion. After identification of the ALL, topologic measurements were undertaken using a digital caliper. Results The ALL could be identified as a tender, pearly structure in front of the anterolateral joint capsule in only 60% of the dissected knee joints. Only 20% of donors had a bilateral ALL while 80% had an ALL only in one side. Mean length, thickness and width as well as topographic measurements were comparable to other available studies investigating fresh-frozen cadavers. Conclusion Anatomy and topography of the ALL seem to be highly variable, but consistent within certain borders. Prevalence has to be argued though as it strongly differs between studies. The impact of an ALL absence, even if only unilateral, needs to be investigated in clinical and imaging studies to finally clarify its importance.</description><identifier>ISSN: 0936-8051</identifier><identifier>EISSN: 1434-3916</identifier><identifier>DOI: 10.1007/s00402-016-2617-3</identifier><identifier>PMID: 28005166</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Aged ; Aged, 80 and over ; Anterior Cruciate Ligament - anatomy &amp; histology ; Arthroscopy and Sports Medicine ; Cadaver ; Dissection - methods ; Female ; Humans ; Knee ; Knee Joint - anatomy &amp; histology ; Ligaments ; Male ; Medicine ; Medicine &amp; Public Health ; Menisci, Tibial - anatomy &amp; histology ; Middle Aged ; Orthopedics ; Studies</subject><ispartof>Archives of orthopaedic and trauma surgery, 2017-02, Vol.137 (2), p.249-255</ispartof><rights>Springer-Verlag Berlin Heidelberg 2016</rights><rights>Archives of Orthopaedic and Trauma Surgery is a copyright of Springer, (2016). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-9119a9398e4c9e6020cc9d54fa6ccca7c5e6619f5ccbb166085fe670ddc307de3</citedby><cites>FETCH-LOGICAL-c372t-9119a9398e4c9e6020cc9d54fa6ccca7c5e6619f5ccbb166085fe670ddc307de3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00402-016-2617-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00402-016-2617-3$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28005166$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Roessler, Philip P.</creatorcontrib><creatorcontrib>Schüttler, Karl F.</creatorcontrib><creatorcontrib>Stein, Thomas</creatorcontrib><creatorcontrib>Gravius, Sascha</creatorcontrib><creatorcontrib>Heyse, Thomas J.</creatorcontrib><creatorcontrib>Prescher, Andreas</creatorcontrib><creatorcontrib>Wirtz, Dieter C.</creatorcontrib><creatorcontrib>Efe, Turgay</creatorcontrib><title>Anatomic dissection of the anterolateral ligament (ALL) in paired fresh-frozen cadaveric knee joints</title><title>Archives of orthopaedic and trauma surgery</title><addtitle>Arch Orthop Trauma Surg</addtitle><addtitle>Arch Orthop Trauma Surg</addtitle><description>Introduction Different dissection studies as well as comparative studies about the anterolateral ligament of the knee (ALL) already exist and the structure’s topology and properties have been shown. However, most of the studies investigating the ligament were performed in embalmed knees, which is thought to change the structural integrity of ligaments and thus the topologic and dynamic measurements. Since the biomechanical function of the ALL is not fully understood until today and a correlation with the pivot shift phenomenon is yet speculative, further studies will have to clarify its definitive importance. Its function as a limiter of internal rotation and lateral meniscal extrusion leads to the assumption of a secondary knee stabilizer. Methods Twenty paired fresh-frozen cadaveric knees of ten donors have been dissected in a layerwise fashion. After identification of the ALL, topologic measurements were undertaken using a digital caliper. Results The ALL could be identified as a tender, pearly structure in front of the anterolateral joint capsule in only 60% of the dissected knee joints. Only 20% of donors had a bilateral ALL while 80% had an ALL only in one side. Mean length, thickness and width as well as topographic measurements were comparable to other available studies investigating fresh-frozen cadavers. Conclusion Anatomy and topography of the ALL seem to be highly variable, but consistent within certain borders. Prevalence has to be argued though as it strongly differs between studies. 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Schüttler, Karl F. ; Stein, Thomas ; Gravius, Sascha ; Heyse, Thomas J. ; Prescher, Andreas ; Wirtz, Dieter C. ; Efe, Turgay</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-9119a9398e4c9e6020cc9d54fa6ccca7c5e6619f5ccbb166085fe670ddc307de3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anterior Cruciate Ligament - anatomy &amp; histology</topic><topic>Arthroscopy and Sports Medicine</topic><topic>Cadaver</topic><topic>Dissection - methods</topic><topic>Female</topic><topic>Humans</topic><topic>Knee</topic><topic>Knee Joint - anatomy &amp; histology</topic><topic>Ligaments</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine &amp; Public Health</topic><topic>Menisci, Tibial - anatomy &amp; histology</topic><topic>Middle Aged</topic><topic>Orthopedics</topic><topic>Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Roessler, Philip P.</creatorcontrib><creatorcontrib>Schüttler, Karl F.</creatorcontrib><creatorcontrib>Stein, Thomas</creatorcontrib><creatorcontrib>Gravius, Sascha</creatorcontrib><creatorcontrib>Heyse, Thomas J.</creatorcontrib><creatorcontrib>Prescher, Andreas</creatorcontrib><creatorcontrib>Wirtz, Dieter C.</creatorcontrib><creatorcontrib>Efe, Turgay</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing &amp; 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However, most of the studies investigating the ligament were performed in embalmed knees, which is thought to change the structural integrity of ligaments and thus the topologic and dynamic measurements. Since the biomechanical function of the ALL is not fully understood until today and a correlation with the pivot shift phenomenon is yet speculative, further studies will have to clarify its definitive importance. Its function as a limiter of internal rotation and lateral meniscal extrusion leads to the assumption of a secondary knee stabilizer. Methods Twenty paired fresh-frozen cadaveric knees of ten donors have been dissected in a layerwise fashion. After identification of the ALL, topologic measurements were undertaken using a digital caliper. Results The ALL could be identified as a tender, pearly structure in front of the anterolateral joint capsule in only 60% of the dissected knee joints. Only 20% of donors had a bilateral ALL while 80% had an ALL only in one side. Mean length, thickness and width as well as topographic measurements were comparable to other available studies investigating fresh-frozen cadavers. Conclusion Anatomy and topography of the ALL seem to be highly variable, but consistent within certain borders. Prevalence has to be argued though as it strongly differs between studies. The impact of an ALL absence, even if only unilateral, needs to be investigated in clinical and imaging studies to finally clarify its importance.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>28005166</pmid><doi>10.1007/s00402-016-2617-3</doi><tpages>7</tpages></addata></record>
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subjects Aged
Aged, 80 and over
Anterior Cruciate Ligament - anatomy & histology
Arthroscopy and Sports Medicine
Cadaver
Dissection - methods
Female
Humans
Knee
Knee Joint - anatomy & histology
Ligaments
Male
Medicine
Medicine & Public Health
Menisci, Tibial - anatomy & histology
Middle Aged
Orthopedics
Studies
title Anatomic dissection of the anterolateral ligament (ALL) in paired fresh-frozen cadaveric knee joints
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