The anterolateral ligament in acute knee trauma: patterns of injury on MR imaging
- PDF / 1,039,375 Bytes
- 8 Pages / 595.276 x 790.866 pts Page_size
- 117 Downloads / 179 Views
SCIENTIFIC ARTICLE
The anterolateral ligament in acute knee trauma: patterns of injury on MR imaging Luke Lintin 1 & Rajat Chowdhury 1 & Phil Yoong 2 & Siok Li Chung 3 & Ramy Mansour 1 & James Teh 1 & David McKean 3 Received: 30 September 2019 / Revised: 1 April 2020 / Accepted: 6 April 2020 # ISS 2020
Abstract Objective To delineate the spectrum of traumatic knee injuries associated with injury of the anterolateral ligament of the knee (ALL). Materials and methods A retrospective review of 200 MRI scans undertaken for acute knee trauma was performed. In each scan, the ALL was scored as normal, sprained or torn. The menisci, ligaments and tendons of each knee were also assessed. Results The mean age was 27.4 years (range, 9–69 years), and 71.5% (n = 143) of the patients were male. The anterolateral ligament (ALL) was graded as ruptured in 17 cases (8.5%), sprained in 58 cases (29%), normal in 116 cases (58%) and not visible in 9 cases (4.5%). Of cases with injury of the ALL (n = 75), there was associated injury of the anterior cruciate ligament (ACL) in 61 cases, medial collateral ligament (MCL) in 51 cases, popliteofibular ligament (PFL) in 29 cases, medial meniscus in 29 cases, lateral meniscus in 24 cases, lateral collateral ligament in 9 cases, posterior cruciate ligament in 8 cases, biceps femoris in 5 cases, popliteus tendon in 4 cases and fluid or oedema was seen adjacent to the iliotibial band in 59 cases. No cases of isolated ALL injury were seen. Conclusions ALL injury is not uncommon in acute knee trauma and is typically associated with significant internal derangement of the knee, especially anterior cruciate ligament rupture, ITB sprain, medial collateral ligament injury, meniscal tears and injury to the popliteofibular ligament. Keywords Anterolateral ligament . ACL . Knee . MRI . Segond fracture
Introduction There has been increasing awareness in the radiological and surgical literature of the importance of anterolateral corner of the knee. The anterolateral ligament (ALL) is one of the principal components of the anterolateral corner and arises from the region of the lateral epicondyle of the femur, in close proximity to the origin of the lateral collateral ligament (LCL) and extends to insert onto the proximal anterolateral tibia, posterior to the insertion of the iliotibial band on Gerdy’s tubercle, in the region on the proximal tibia from where * David McKean [email protected] 1
Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Trust, Oxford, UK
2
Royal Berkshire NHS Foundation Trust, Reading, UK
3
Stoke Mandeville Hospital, Buckingahmshire Healthcare NHS Trust, Aylesbury, UK
Segond fractures avulse, suggesting that the Segond fracture is actually a bony avulsion of the ALL [1–7]. The ALL is readily identifiable on MRI on coronal and axial planes and has attachments to the body of the lateral meniscus (Figs. 1, 2 and 3). It has been hypothesised in previous studies that the ALL and anterolateral corner (ALC) structures are important in providing both static and dynamic cons
Data Loading...
