The anterolateral ligament (ALL) is a ligamentous thickening of the capsular ligament on the outer side of the knee, in front of the lateral collateral ligament.
|The anterolateral ligament (ALL) and its relationship to the other lateral structures (lateral collateral ligament and popliteus tendon)|
The re-discovered ligament
Despite earlier decriptions in the literature, this structure was not widely recognised by knee surgeons until 2013 when evidence for its anatomy and importance was presented in a PhD dissertation. Since then many knee surgeons have felt that it is the 'missing link' in understanding anterolateral rotational instability - the kind of knee instability that gives a very positive result when the surgeon performs the pivot shift test while assessing the anterior cruciate ligament. Damage to the anterolateral ligament is thought to explain why some patients still have rotational instability even after anterior cruciate ligament reconstruction.
Anterolateral Ligament of the Knee: Anatomy, Function, Imaging, and Treatment. Patel RM and Brophy RH. Am J Sports Med. 2018 Jan;46(1):217-223. doi: 10.1177/0363546517695802. Epub 2017 Mar 20.
Anterolateral Ligament of the Knee: Back to the Future in Anterior Cruciate Ligament Reconstruction. Bonasia DE, D’Amelio A, Pellegrino P, Rosso F and Rossi R. Orthop Rev (Pavia). 2015 Jun 3; 7(2): 5773.
Anterolateral Ligament Expert Group consensus paper on the management of internal rotation and instability of the anterior cruciate ligament - deficient knee. Sonnery-Cottet B, Daggett M, Fayard J-M, Ferretti A, Helito CP, Lind M, Monaco E, de Pádua VBC, Thaunat M, Zaffagnini S, Zijl and Claes S. J Orthop Traumatol. 2017 Jun; 18(2): 91–106.