Heckmann Nathanael, Sivasundaram Lakshmanan, Villacis Diego, Kleiner Matthew, Yi Anthony, White Eric, Rick Hatch George F
Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, California, U.S.A..
Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, California, U.S.A.
Arthroscopy. 2016 May;32(5):844-8. doi: 10.1016/j.arthro.2015.11.022. Epub 2016 Feb 9.
To identify the radiographic position of the origin and insertion of the anterolateral ligament (ALL) of the knee on a lateral radiograph.
Twelve unpaired, fresh-frozen cadaveric knees were dissected to expose the ALL. The origin and insertion of the ALL on each cadaver were then tagged using 2-mm radiopaque beads. True lateral fluoroscopic views of the knee were then obtained, and the distance from known radiographic landmarks was recorded by 2 reviewers.
The origin of the ALL was found at a distance that is 37.0 ± 9.2% of the total anterior-posterior length of the femoral condyle from the posterior edge as measured along Blumensaat's line. The insertion was located at a distance that is 56.1 ± 6.9% of the total length of the tibial plateau from the posterior edge. The origin of the ALL is 5 mm posterior to a line from the posterior femoral cortex and 9 mm distal to a line along Blumensaat's line. The insertion is 4 mm anterior to the 50% mark of the anterior-posterior width of the tibia, 14 mm distal to the articular surface.
The origin and insertion of the ALL can be accurately identified using intraoperative fluoroscopy.
Determining radiographic parameters for the ALL will assist in developing accurate surgical techniques for ALL reconstruction.
在侧位X线片上确定膝关节前外侧韧带（ALL）起点和止点的影像学位置。
解剖12个未配对的新鲜冷冻尸体膝关节以暴露ALL。然后用2毫米不透X线的珠子标记每个尸体上ALL的起点和止点。接着获得膝关节的真正侧位透视图像，由2名观察者记录距已知影像学标志的距离。
发现ALL的起点位于沿布卢门萨特线从后缘测量的股骨髁前后总长度的37.0±9.2%处。止点位于从后缘测量的胫骨平台总长度的56.1±6.9%处。ALL的起点在股骨后皮质线后方5毫米处，在沿布卢门萨特线的线远端9毫米处。止点在胫骨前后宽度50%标记前方4毫米处，关节面远端14毫米处。
术中透视可准确识别ALL的起点和止点。
确定ALL的影像学参数将有助于开发准确的ALL重建手术技术。
