(Fig 3-B.40, 41) Anterolateral Ligament Reconstruction

https://youtu.be/u9UvwwCb2EU

https://youtu.be/6WOItzqJj1g

 

📌Anterolateral Ligament (ALL) Reconstruction

 

• The Anterolateral Ligament (ALL) is an important secondary stabilizer that resists excessive internal rotation and anterior tibial translation. 
• Combined ACL and ALL reconstruction may lead to lower graft failure rates and improved patient outcomes.

✅ALL Reconstruction Technique:

• Femoral tunnel: Slightly posterior and proximal (4mm posterior, 8mm proximal) to the lateral femoral epicondyle
• Tibial tunnel: Approximately 5-10mm distal to the joint line, halfway between the fibular head and Gerdy's tubercle
• ALL graft follows the anatomical oblique course, anterior and inferior towards the tibia, through a soft tissue tunnel underneath the iliotibial band (ITB) and superficial to the lateral collateral ligament (LCL)

 

✅ Potential Postoperative ALL Complications:

1️⃣ Injury to LCL due to proximity of femoral insertions
Risk: The proximity of the ALL and LCL femoral insertions can lead to iatrogenic injuries during femoral tunnel confection.

 

2️⃣ Malposition of fixation devices (screw migration)
Screw migration is a potential complication, particularly with bioabsorbable interference screws after ACL reconstruction.

 

3️⃣ Complications involving the ACL graft in combined ACL/ALL reconstructions
Risk: Combined ACL and ALL reconstructions are susceptible to complications affecting the ACL part of the graft.

Magn Reson Imaging Clin N Am 30 (2022) 261–275

Skeletal Radiology (2020) 49:1037–1049

Skeletal Radiology (2020) 49:1037–1049

"Visualizing MSK Radiology: A Practical Guide to Radiology Mastery"

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