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The Anterolateral ligament

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The anterolateral ligament is the newest anatomical find in the orthopedic world of medicine to date. Dr. Steven Claes and Dr. Johan Bellemans are two orthopedic surgeons from the University Hospital of Leuven that have spent four years researching pivot shifts in the knee and why they still seem to occur even after the anterior cruciate ligament (ACL) had been successfully operated on.

The knee as a whole is an extremely complex and delicate anatomical instrument that is usually subject to wear and tear especially among athletes, therefore extensive research and new surgical techniques are continuously being tried out in order to keep the knee as healthy and as functional as possible for as long as is realistically allowed.

As it happens, the theory that an extra ligament could exist on knee has been around since 1879 when a french surgeon named Paul Segond documented his findings. This hypothesis was further examined by the Belgian surgeons from Leuven, in order to solve the mystery as to the continuing complaint of joint pivot shifts, who managed to positively confirm the theory.

Bones and ligaments of lower leg
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Bones, ligaments and joints of the knee and the lower leg.

The Anatomy of the Anterolateral Ligament (ALL)

Since 2013, the anterolateral ligament has been confirmed to originate from the lateral epicondyle of the femur and insert into the anterolateral aspect of the proximal tibia. It has been debated since if the origin is indeed where it has been previously stated or whether it comes from the lateral femoral condyle, which remains to be seen. This anatomical structure is thought to be present in up to 79% of the world’s current human population and functions to stabilize the knee during medial rotation. Therefore, when a patient presents with a pivot shift and an anterior cruciate ligament (ACL) injury, it is now known that this occurrence is more than likely due to an anterolateral ligament (ALL) injury.

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Show references

References:

  • Gretchen Reynolds. Doctors a new knee ligament. The New York Times. November 13, 2013.
  • Caleb Garling. The anterolateral ligament: A life and (slight) death of wrong information on the Internet. SF Gate. November 8, 2013.
  • Anna Hodgekiss, Emma Innes. Scientists discover a new body part in the knee - and it could explain why so many injured joints give way during exercise. Mail Online. November 6, 2013.
  • Orthopaedic surgeon says anterolateral ligament not "new" but promising for ACL injuries. Medical Xpress. November 11, 2013.

Author:

  • Dr. Alexandra Sieroslawska

Illustrators:

  • Anterolateral ligament - Yousun Koh 
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