Abstract
Recent research has suggested that the anterolateral ligament (ALL) of the knee may
have an important role in preventing persistent rotatory instability following anterior
cruciate ligament (ACL) reconstruction.
For this review, we performed a thorough literature search and identified the significant
steps in the improvement of our understanding. This has progressed from historical
reports to accurate characterization of the attachments and dimensions of the ALL
through anatomical and histological studies. Alongside this, biomechanical data have
demonstrated the role of this structure throughout the range of movement of the knee.
Furthermore, the appearance of the ALL on magnetic resonance imaging has been comprehensibly
described and radiological markers have been defined as a basis for suggested reconstructive
procedures using fluoroscopy.
We present a comprehensive review of the evolution of our understanding about this
structure. Key advances in our understanding of the dimensions and attachments will
guide research into reconstructive options. Further work is needed to determine the
biomechanical and clinical outcome of extra-articular reconstruction of the ALL alongside
ACL reconstruction.
Keywords
anterolateral ligament - anterior cruciate ligament reconstruction - knee anatomy
- knee biomechanics