Topographic and Anatomical Features of Anterolateral Ligament of the Knee

Purpose of the study: to investigate the occurrence, severity and topographic features of anterolateral ligament (AL) in the vien of stabilizing procedures on the knee. Materials and methods: the study included 60 samples of lower extremities obtained from 30 unfixed corpses of people who died at the age from 69 to 99 years. Topographic and anatomical study was performed with knee flexion at 90 degrees with internal rotation of lower extremity using basic surgical instruments set and precision preparation instruments set. When the ligament was identified, relationship with the lateral meniscus body was evaluated, relationship with peroneal collateral ligament (mainly by connective fibers) and the presence of lateral lower knee vessels (artery and veins) were evaluated. Also, the place of ligament attachment on lateral epicondyle of femur and lateral condyle of tibia were measured. Results: the incidence of AL in studied age group is 56.6 percent. AL was observed in both knee joints in 100% of cases. In women AL was observed in 66.7% (24 joints out of 36), in men - 41.6% (10 joints out of 24). The average length of the AL was 38.5 +/- 4.4 mm. The average width at the level of joint gap - 4.45 +/- 0.85 mm. The location of the attachment to the lateral epicondyle of the femur was represented in three anatomical variants: posterior and proximal to the lateral collateral ligament - 64.7%, anterior to the lateral collateral ligament - 23.5%, in the place of attachment of popliteal muscle tendon or next to it - 11.8%. The place of attachment on lateral condyle of the tibia is typical - approximately in the middle of the line from fibula head to Gerdy tubercle. Conclusion. Based on the authors' findings and findings of foreign studies the optimal area for proximal channel formation is the posterior position and proximal to place of lateral collateral ligament beginning. Also, the anatomical regularity of lateral lower knee vessels is obtained, that allows to preserve one of the main blood supply sources of anterolateral area of the knee joint.