The Knee Anterolateral Ligament is Present in 82% of North American and 65% of European But Only in 46% of Asian Studies: A Systematic Review of Frequency and Anatomy.

Erik Hohmann, Natalie Keough, Maketo Molepo, Robert Arciero, Andreas Imhoff
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Abstract

Purpose: To perform an updated systematic review on the prevalence and morphological characteristics of the anterolateral ligament (ALL) in human cadaveric specimens.

Methods: Medline, Embase, Scopus, and Google Scholar were searched for studies from 2012 to 2024 describing the morphology. Study quality was assessed using CASP checklist and QUACS scale. Heterogeneity was analysed with the I2 statistic, funnel plot, and Q-test. Mean effect size and 95% prediction intervals were calculated. Prevalence and anatomical measurements (length, width, thickness) were analysed using mean and standard deviations.

Results: Thirty studies were included. CASP identified three low-quality studies. Twelve studies met the QUACS quality threshold. The prevalence of the ALL was 61.7% (82% North America, 64.9% Europe, 45.8% Asia). The femoral insertion showed variability near the lateral femoral epicondyle and lateral collateral ligament, while the tibial insertion was midway between Gerdy's tubercle and fibular head. Histological analysis revealed 60% of studies identified ligamentous tissue similar to the ACL. The mean ALL length was 39.7 mm, width 5.5 mm, and thickness 1.5 mm, with no significant morphological differences among populations.

Conclusion: This systematic review reveals that the ALL is present in 61.7%, with prevalence rates of 82% in North American studies, 65% in European studies, and 46% in Asian studies. The femoral insertion exhibited substantial variability at/around the lateral femoral epicondyle and LCL, lacking consistency. The tibial insertion was more consistently described as being located about halfway between Gerdy's tubercle and the fibular head. Histological analysis showed that 60% of the included studies identified the ALL as containing ligament-like or ligamentous tissue. The mean length of the ALL was 39.9 mm (range 31-59 mm), the mean width was 5.7 mm (range 2.2-9.0 mm), and the mean thickness was 1.5 mm (range 1.3-2.7 mm). No significant ethnic population differences were observed in the morphological measures.

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膝关节前外侧韧带在 82% 的北美和 65% 的欧洲研究中存在,但在 46% 的亚洲研究中仅存在:频率和解剖学系统回顾。
目的:对人体尸体标本中前外侧韧带(ALL)的患病率和形态特征进行最新的系统综述:方法:检索Medline、Embase、Scopus和Google Scholar上2012年至2024年描述该形态的研究。研究质量采用CASP核对表和QUACS量表进行评估。使用 I2 统计量、漏斗图和 Q 检验分析异质性。计算平均效应大小和 95% 预测区间。患病率和解剖测量(长度、宽度、厚度)采用平均值和标准差进行分析:共纳入 30 项研究。CASP 确定了三项低质量研究。12项研究达到了QUACS质量阈值。ALL的发病率为61.7%(北美82%,欧洲64.9%,亚洲45.8%)。股骨插入部位在股骨外上髁和外侧副韧带附近,而胫骨插入部位在Gerdy's结节和腓骨头之间。组织学分析显示,60%的研究发现了与前交叉韧带相似的韧带组织。ALL的平均长度为39.7毫米,宽度为5.5毫米,厚度为1.5毫米,不同人群之间没有明显的形态差异:本系统综述显示,61.7%的人存在ALL,其中北美研究的患病率为82%,欧洲研究的患病率为65%,亚洲研究的患病率为46%。股骨插入部位在股骨外上髁和LCL处/周围表现出很大的差异性,缺乏一致性。对胫骨插入点的描述较为一致,即位于Gerdy's结节和腓骨头之间的中点。组织学分析显示,60%的纳入研究认为ALL包含韧带样组织或韧带组织。ALL的平均长度为39.9毫米(范围为31-59毫米),平均宽度为5.7毫米(范围为2.2-9.0毫米),平均厚度为1.5毫米(范围为1.3-2.7毫米)。在形态测量方面没有观察到明显的种族人群差异。
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来源期刊
CiteScore
9.30
自引率
17.00%
发文量
555
审稿时长
58 days
期刊介绍: Nowhere is minimally invasive surgery explained better than in Arthroscopy, the leading peer-reviewed journal in the field. Every issue enables you to put into perspective the usefulness of the various emerging arthroscopic techniques. The advantages and disadvantages of these methods -- along with their applications in various situations -- are discussed in relation to their efficiency, efficacy and cost benefit. As a special incentive, paid subscribers also receive access to the journal expanded website.
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