Knee Surg Relat Res.  2019 Dec;31(4):e12. 10.1186/s43019-019-0012-4.

The anterolateral ligament of the knee joint: a review of the anatomy, biomechanics, and anterolateral ligament surgery

  • 1Department of Orthopaedic Surgery, Dongguk University Ilsan Hospital, 814 Siksadong, Ilsandonggu, Goyangsi, Gyeonggido 411-773, Korea.
  • 2Department of Orthopaedic Surgery, University of California, Irvine, CA, USA.
  • 3Department of Orthopaedic Surgery, NYU Langone Orthopedic Hospital, New York, New York, USA.
  • 4Orthopaedic Biomechanics Laboratory, Congress Medical Foundation, Pasadena, CA, USA.


Residual knee instability and low rates of return to previous sport are major concerns after anterior cruciate ligament (ACL) reconstruction. To improve outcomes, surgical methods, such as the anatomical single-bundle technique or the double-bundle technique, were developed. However, these reconstruction techniques failed to adequately overcome these problems, and, therefore, new potential answers continue to be of great interest. Based on recent anatomical and biomechanical studies emphasizing the role of the anterolateral ligament (ALL) in rotational stability, novel surgical methods including ALL reconstruction and anterolateral tenodesis have been introduced with the possibility of resolving residual instability after ACL reconstruction. However, there is still little consensus on many aspects of the ALL, including: several anatomical issues, appropriate indications for ALL surgery, and the optimal surgical method and graft choice for reconstruction surgery. Therefore, further studies are necessary to advance our knowledge of the ALL and its contribution to knee stability.


Anterior cruciate ligament; Knee instability; Anterolateral ligament; ALL reconstruction; Anterolateral tenodesis
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