Anatomical, Biomechanical and Radiological Characteristics of Anterolateral Ligament

Year 2020, Volume: 7 Issue: 2, 111 - 115, 31.08.2020

Murat Demirel

Abstract

Anterior cruciate ligament (ACL) ruptures in the knee joint are one of the most frequent injuries; however, problems with obtaining natural dynamic knee function with current surgical reconstruction methods are frequently reported. The aim of anatomic ACL reconstruction is to restore the anatomy and the kinematics of the knee. The failure to provide full rotational stability in ACL injured knees, strengthened the idea that procedures such as extra-articular tenodesis reconstructions, which aim to strengthen the structures in the lateral region of the knee, should be added to ACL reconstruction operations. Anatomically, these clinical observations arouse the interest in conducting studies which aim to examine the structural content of the anterolateral part of the knee and its stabilizing contributions. As a result, some research has been done, which can be called the rediscovery of the anterolateral ligament (ALL) including its detailed examinations. In addition, the close relationship between ACL ruptures and ALL injuries and the association of residual anterolateral rotational instability in pivot shift test have led to an increase in the interest of the anatomic and structural features of ALL. ALL was first mentioned by Segond in 1879 in the study where he described the extension of the iliotibial band (ITB) during internal rotation. Segond described this structure as a pearl-like, fibrous band. But the study, which aroused the main interest in ALL anatomy, was made by Claes et al., and at that time, many written and visual media reported "A new connection was found in the knee".

Keywords

anterolateral ligament, pivot shift, knee anatomy

Anterolateral Ligamanın Anatomik, Biyomekanik ve Radyolojik Özellikleri

Abstract

Diz ekleminde ön çapraz bağ (ÖÇB) yırtıkları en sık görülen yaralanmalarındandır ancak halen güncel cerrahi rekonstrüksiyon yöntemleri ile doğal dinamik diz fonksiyonunu elde etme ile ilgili sorunlar sıklıkla bildirilmektedir. Anatomik ÖÇB rekonstrüksiyonunun amacı dizin normal anatomi ve kinematiğini tekrar sağlamaktır. ÖÇB yaralanmalı dizlerde tam rotasyonel stabiliteyi sağlamadaki başarısızlıklar, dizin lateral bölgesindeki yapıların güçlendirilmesi amacını taşıyan eklem-dışı tenodez rekonstrüksiyonları gibi prosedürlerin, ÖÇB rekonstrüksiyonu ameliyatlarına eklenmesi gerekliliği fikrini güçlendirmiştir. Anatomik olarak, bu klinik gözlemler dizin anterolateral bölgesindeki yapıların yapısal içerik ve stabilize edici katkılarının değerlendirilmesi amaçlarını taşıyan çalışmaların yapılmasına olan ilgiyi uyandırmıştır. Bunun sonucunda anterolateral ligament (ALL) gibi bir yapının yeniden keşfi olarak adlandırılabilecek ayrıntılı incelemelerini içeren araştırmalar yapılmıştır. Ayrıca, ÖÇB yırtıkları ile ALL yaralanmalarının yakın ilişkisi ve pivot shift testinde rezidüel anterolateral rotasyonel instabilitenin birlikteliği, ALL’in anatomik ve yapısal özelliklerine olan ilginin artmasına da sebep olmuştur. ALL ilk kez Segond tarafından 1879 yılında, İliotibial bandın (ITB) iç rotasyon sırasında gerilmesini tanımladığı çalışmada belirtilmiştir. Bu yapıyı Segond, inci benzeri, fibröz bir bant olarak tanımlamıştır. Ama ALL anatomisine esas ilginin artmasını sağlayan çalışma Claes ve ark., tarafından yapılmış ve o dönemde bir çok yazılı ve görsel basında ‘’Dizde yeni bir bağ bulundu’’ şeklinde haberler yer almıştır.

Keywords

anterolateral ligament, pivot shift, Diz Anatomisi

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