Length Changes of the Lateral Knee: Fibular Collateral Ligament, Anterolateral Ligament, and Iliotibial Band Fibers.
Background: The lateral knee is stabilized by the fibular collateral ligament (FCL), anterolateral ligament (ALL), and iliotibial band (ITB) fibers. Understanding their flexion-dependent behavior is critical for guiding graft fixation during reconstruction. Hypothesis/Purpose: The hypothesis was tha...
| Publicado en: | American Journal of Sports Medicine Vol. 54; no. 11; pp. 2713 - 2722 |
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| Autores principales: | , , , , , , , , , |
| Formato: | pictorial research tables/charts Journal Article |
| Publicado: |
Sage Publications Inc.
Sep2026
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=196600590&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 196600590 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 03635465 ASM jtl: American Journal of Sports Medicine issn: 03635465 maglogo: Y pubinfo: dt: Sep2026 vid: 54 iid: 11 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 196600590 195867947 196600590 196600590 10.1177/03635465261468548 196600590 ppf: 2713 ppct: 9 formats: tig: atl: Length Changes of the Lateral Knee: Fibular Collateral Ligament, Anterolateral Ligament, and Iliotibial Band Fibers. aug: au: Augustin, Edouard J. Oppenheim, Zachary R. Vega, Jose Gomez Verdejo, Fernando Casanova, Felipe J. Escribano, German Koluman, Ali Can Bi, Andrew S. Chahla, Jorge Yanke, Adam B. affil: Rush University Medical Center, Chicago, Illinois, USA sug: subj: Knee Joint Anatomy and Histology Fibula Anatomy and Histology Collateral Ligaments Physiology Ligaments, Articular Anatomy and Histology Iliotibial Band Anatomy and Histology Flexion Tenodesis Grafts Human Cadaver United States Aged Biomechanics Descriptive Research T-Tests Wilcoxon Signed Rank Test Funding Source Surgery, Reconstructive Aged: 65+ years ab: Background: The lateral knee is stabilized by the fibular collateral ligament (FCL), anterolateral ligament (ALL), and iliotibial band (ITB) fibers. Understanding their flexion-dependent behavior is critical for guiding graft fixation during reconstruction. Hypothesis/Purpose: The hypothesis was that the FCL and ALL would shorten with flexion, while ITB fibers would show more minor, transient changes. The purpose was to characterize native length changes of these structures in cadaveric knees. Study Design: Descriptive laboratory study. Methods: Ten fresh-frozen knees were dissected with preservation of lateral soft tissue attachments. Bony landmarks were marked for the attachment sites: FCL (n = 10), ALL (n = 7), and ITB (n = 10 distal Kaplan fibers, n = 9 proximal). A 3-dimensional digitizer recorded coordinates at 0°, 15°, 30°, 45°, 60°, and 90° of flexion. Attachment distances were calculated, and paired t tests or Wilcoxon tests (based on Shapiro-Wilk normality) compared 0° with each flexion angle. Results: Distances between the FCL and ALL attachment sites progressively decreased with flexion, with mean reductions of −7.59 and −6.44 mm, respectively, from 0° to 90° (both P ≤.05). Distances from the Gerdy tubercle to the distal and proximal Kaplan attachments of the ITB increased significantly by 2 to 6 mm between 15° and 60° before returning toward baseline at 90°: distal Kaplan, −0.78 mm (P =.853); proximal Kaplan, −3.99 mm (P =.506). Conclusion: FCL and ALL attachment distances decreased throughout flexion. In contrast, the distances from the Gerdy tubercle to the proximal and distal Kaplan attachments demonstrated midflexion lengthening with a return toward baseline at deeper flexion angles, reflecting relative isometry of these ITB segments. This study is the first to describe the simultaneous length change behavior of all 3 structures, providing integrated anatomic data that may inform graft tensioning and fixation strategies for ALL, FCL, and lateral extra-articular tenodesis reconstruction of the lateral knee. Clinical Relevance: The relative isometry observed in ITB attachment distances suggests that lateral extra-articular tenodesis graft fixation may be less sensitive to knee flexion angle. In contrast, the flexion-dependent decreases in FCL and ALL attachment distances suggest that fixation at knee flexion angles closer to extension may be favorable for avoiding overconstraint in reconstruction of these ligaments. These findings are anatomic and descriptive rather than prescriptive. Further loaded biomechanical studies are needed to determine optimal graft tensioning protocols. pubtype: Academic Journal doctype: pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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