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TOPOGRAPHIC AND ANATOMICAL FEATURES OF ANTEROLATERAL LIGAMENT OF THE KNEE
- Authors: Goncharov E.N.1,2, Koval O.A.2, Krasnov G.O.1, Mironov A.N.3, Goncharov N.G.1,2
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Affiliations:
- Russian Medical Academy of Nonstop Professional Education
- Central Clinical Hospital Russian Academy of Science
- Inozemtsev State Clinical Hospital
- Issue: Vol 24, No 1 (2018)
- Pages: 88-95
- Section: THEORETICAL AND EXPERIMENTAL STUDIES
- URL: https://journal.rniito.org/jour/article/view/951
- DOI: https://doi.org/10.21823/2311-2905-2018-24-1-88-95
- ID: 951
Cite item
Abstract
Background: anterolateral ligament (ALL) is known since it was found in 1879 by Paul Segond. During more than 130 years this anatomical structure was not popular, later it became especially relevant, when its involvement in knee joint rotational stability was demonstrated by different studies. However, data about anterolateral ligament in the knee joint is controversial and limited so further research is necessary.
Purpose of the study: to investigate frequency of occurrence, severity and features of topography of anterolateral ligament of the knee joint in the context of stabilizing procedures on the knee joint.
Materials and methods: the study included 60 samples of lower limbs obtained from 30 unfixed corpses of people who died at the age from 69 to 99 years. Topography-anatomical study was performed with knee bent at 90° with internal rotation of lower leg using basic surgical instruments set and precision preparation instruments set. When the ligament was identified, relationship with the lateral meniscus body was evaluated, relationship with peroneal collateral ligament (mainly by connective fibers) and the presence of lateral lower knee vessels (artery and veins) were evaluated. Also, the place of ligament attachment on lateral epicondyle of femur and lateral condyle of tibia were measured.
Results: the incidence of ALL in studied age group is 56.6 percent. ALL was observed in both knee joints in 100% of cases. In women ALL was observed in 66.7% (24 joints out of 36), in men — 41.6% (10 joint out of 24). The average length of the ALL was 38.5±4.4 mm. The average width at the level of joint gap — 4.45±0.85 mm.
The location of the attachment to the lateral epicondyle of the femur was represented in three anatomical variants: posterior and proximal to the lateral collateral ligament — 64.7%, anterior to the lateral collateral ligament — 23.5%, in the place of attachment of popliteal muscle tendon or next to it — 11.8%. The place of attachment on lateral condyle of the tibia is typical — approximately in the middle of the line from fibula head to Gerdy tubercle.
Conclusion. Based on the authors’ findings and findings of foreign studies the optimal area for proximal channel formation is the posterior position and proximal to place of lateral collateral ligament beginning. Also, the anatomical regularity of lateral lower knee vessels is obtained, that allows to preserve one of the main blood supply sources of anterolateral area of the knee joint.
About the authors
E. N. Goncharov
Russian Medical Academy of Nonstop Professional Education;Central Clinical Hospital Russian Academy of Science
Author for correspondence.
Email: goncharoven@gmail.com
Cand. Sci. (Med.), Assistant lecturer, Traumatology and Orthopedics Department
Orthopaedic Surgeon, Traumatology and Orthopedics Center
2/1, ul. Barrikadnaya, 123242, Moscow
1a, Litovskii bul’var, 117593, Moscow
Russian FederationO. A. Koval
Central Clinical Hospital Russian Academy of Science
Email: fake@neicon.ru
Orthopaedic Surgeon, Traumatology and Orthopedics Center
1a, Litovskii bul’var, 117593, Moscow
Russian FederationG. O. Krasnov
Russian Medical Academy of Nonstop Professional Education
Email: fake@neicon.ru
Postgraduate Student, Traumatology and Orthopedics Department
2/1, ul. Barrikadnaya, 123242, Moscow
Russian FederationA. N. Mironov
Inozemtsev State Clinical Hospital
Email: fake@neicon.ru
the Head of Polytrauma and Pelvic Injury Department
1, Fortunatovskaya ul., 105187, Moscow
Russian FederationN. G. Goncharov
Russian Medical Academy of Nonstop Professional Education;Central Clinical Hospital Russian Academy of Science
Email: fake@neicon.ru
Dr. Sci. (Med.), professor, Head of Department, Traumatology and Orthopedics Department
Head of Department, Traumatology and Orthopedics Center
2/1, ul. Barrikadnaya, 123242, Moscow
1a, Litovskii bul’var, 117593, Moscow
Russian FederationReferences
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