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World J Clin Cases. Jul 26, 2022; 10(21): 7215-7223
Published online Jul 26, 2022. doi: 10.12998/wjcc.v10.i21.7215
Anatomy of the anterolateral ligament of the knee joint
Jun-Gu Park, Seung-Beom Han, Hye Chang Rhim, Ok Hee Jeon, Ki-Mo Jang
Jun-Gu Park, Seung-Beom Han, Ki-Mo Jang, Department of Orthopaedic Surgery, Anam Hospital, Korea University College of Medicine, Seoul 02841, South Korea
Hye Chang Rhim, Department of Medicine, MetroWest Medical Center/Tufts University School of Medicine, Framingham, MA 02111, United States
Ok Hee Jeon, Department of Biomedical Sciences, Korea University College of Medicine, Seoul 02841, South Korea
Author contributions: Jang KM and Park JG wrote the paper; Park JG, Han SB, and Jang KM performed data collection and analysis; Jang KM, Rhim HC, Jeon OH and Han SB performed review and editing.
Supported by a grant of Korea University Anam Hospital, Seoul, Republic of Korea, No. K2209741.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ki-Mo Jang, MD, PhD, Associate Professor, Doctor, Staff Physician, Surgeon, Department of Orthopaedic Surgery, Anam Hospital, Korea University College of Medicine, 73 Inchon-Ro, Seongbuk-gu, Seoul 02841, South Korea. kimo98@hanmail.net
Received: March 8, 2022
Peer-review started: March 8, 2022
First decision: April 13, 2022
Revised: April 26, 2022
Accepted: June 3, 2022
Article in press: June 3, 2022
Published online: July 26, 2022
Processing time: 124 Days and 18.5 Hours
Abstract

Despite remarkable improvements in clinical outcomes after anterior cruciate ligament reconstruction, the residual rotational instability of knee joints remains a major concern. The anterolateral ligament (ALL) has recently gained attention as a distinct ligamentous structure on the anterolateral aspect of the knee joint. Numerous studies investigated the anatomy, function, and biomechanics of ALL to establish its potential role as a stabilizer for anterolateral rotational instability. However, controversies regarding its existence, prevalence, and femoral and tibial insertions need to be addressed. According to a recent consensus, ALL exists as a distinct ligamentous structure on the anterolateral aspect of the knee joint, with some anatomic variations. The aim of this article was to review the updated anatomy of ALL and present the most accepted findings among the existing controversies. Generally, ALL originates slightly proximal and posterior to the lateral epicondyle of the distal femur and has an anteroinferior course toward the tibial insertion between the tip of the fibular head and Gerdy’s tubercle below the lateral tibial plateau.

Keywords: Knee joint; Anatomy; Anterolateral ligament; Anterior cruciate ligament; Anterolateral rotational instability; Anterolateral ligament reconstruction

Core Tip: Although there are some anatomical variations in the anterolateral ligament (ALL), the most recent studies agree that it exists as a distinct ligamentous structure on the anterolateral aspect of the knee joint. ALL reconstruction can be a solution for residual rotational instability after anterior cruciate ligament reconstruction. Further investigations are necessary to resolve the controversies regarding ALL anatomy and to establish appropriate ALL reconstruction techniques.