Anatomic and histological study of the anterolateral aspect of the knee: a SANTI Group investigation

Daggett, M, Stephenson, C, Dobson, J, Whitaker, A, Redler, A, Monaco, E, Wright, B, Saithna, A ORCID: https://orcid.org/0000-0002-2408-5307 and Sonnery-Cottet, B, 2018. Anatomic and histological study of the anterolateral aspect of the knee: a SANTI Group investigation. Orthopaedic Journal of Sports Medicine, 6 (10). ISSN 2325-9671

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Abstract

Background: The structure and function of the anterolateral aspect of the knee have been significantly debated, with renewed interest in this topic since the description of the anterolateral ligament (ALL).
Purpose: To define and describe the distinct structures of the lateral knee and to correlate the macroscopic and histologic anatomic features.
Study Design: Descriptive laboratory study.
Methods: Twelve fresh-frozen human cadavers were used for anatomic analysis. In the left knee, a layer-by-layer dissection and macroscopic analysis were performed. In the right knee, an en bloc specimen was obtained encompassing an area from the Gerdy tubercle to the posterior fibular head and extending proximally from the anterior aspect to the posterior aspect of the lateral femoral epicondyle. The en bloc resection was then frozen, sliced at the level of the joint line, and reviewed by a musculoskeletal pathologist.
Results: Macroscopically, the lateral knee has 4 main layers overlying the capsule of the knee: the aponeurotic layer, the superficial layer including the iliotibial band (ITB), the deep fascial layer, and the ALL. Histologically, 8 of 12 specimens demonstrated 4 consistent, distinct structures: the ITB, the ALL, the lateral collateral ligament, and the meniscus.
Conclusion: The lateral knee has a complex orientation of layers and fibers. The ALL is a distinct structure from the ITB and is synonymous to the previously described capsulo-osseous layer of the ITB.
Clinical Relevance: Increasingly, lateral extra-articular procedures are performed at the time of anterior cruciate ligament reconstruction. Understanding the anatomic features of the anterolateral aspect of the knee is necessary to understand the biomechanics and function of the structures present and allows surgeons to attempt to replicate those anatomic characteristics when performing extra-articular reconstruction.

Item Type:	Journal article
Publication Title:	Orthopaedic Journal of Sports Medicine
Creators:	Daggett, M., Stephenson, C., Dobson, J., Whitaker, A., Redler, A., Monaco, E., Wright, B., Saithna, A. and Sonnery-Cottet, B.
Publisher:	SAGE in association with the American Orthopaedic Society for Sports Medicine
Date:	October 2018
Volume:	6
Number:	10
ISSN:	2325-9671
Identifiers:	Number Type 10.1177/2325967118799970 DOI
Rights:	© The Author(s) 2018. This open-access article is published and distributed under the Creative Commons Attribution - NonCommercial - No Derivatives License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits the noncommercial use, distribution, and reproduction of the article in any medium, provided the original author and source are credited. You may not alter, transform, or build upon this article without the permission of the Author(s). For article reuse guidelines, please visit SAGE’s website at http://www.sagepub.com/journals-permissions.
Divisions:	Schools > School of Science and Technology
Record created by:	Jill Tomkinson
Date Added:	06 Nov 2018 14:04
Last Modified:	06 Nov 2018 14:07
URI:	https://irep.ntu.ac.uk/id/eprint/34858

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