背景:对于存在旋转不稳的前交叉韧带损伤是目前研究的热点,进一步认识前外侧韧带的解剖学和生物力学可以对膝关节旋转稳定性的恢复起到指导意义。目的:系统回顾当前膝关节前外侧韧带的文献,明确膝关节前外侧韧带的发生率、解剖关系、形态、组织学以及生物力学作用和损伤机制。方法:由第一作者检索Pub Med/Medline数据库发表的关于膝关节前外侧韧带的论文。检索内容包括:incidence,anatomy,morphometry,biomechanics,histology of the ALL,并包括关于"Segond"骨折,并在在中国知网数据库、万方数据库、维普数据库检索"膝关节、前外侧结构、"Segond"骨折",时间跨度从1878至2015年。并对检索内容进行归纳、总结、分析。共检索出文献362篇,其中英文文献342篇,中文文献20篇。按照纳入和排除标准筛选,共纳入42篇文献。结果与结论:前外侧韧带出现率在83%-100%,对于前外侧韧带的骨性抵止点的描述差异很小。前外侧韧带在股骨抵止点位于外侧副韧带股骨抵止点的前侧及远端,跨越关节斜行插入到腓骨小头和胫骨的"Gerdy"结节之间。文献关于前外侧韧带的解剖和形态学的描述不同点在于:前外侧韧带在外侧半月板及关节囊附着部位的解剖。前外侧韧带主要的生物力学作用是控制胫骨过度内旋,组织学上微观结构为:平行状的纤维样韧带组织。通过前外侧韧带的胫骨附着点的撕脱骨折("Segond"骨折)的部位可以准确显示前外侧韧带的胫骨足印点。前外侧韧带是膝关节前外侧面上独特的韧带组织结构,它可以控制胫骨过度内旋,膝关节过度屈曲内旋可引起"Segond"骨折。
BACKGROUND: Anterior cruciate ligament injury accompanied by unstable rotation is a hotspot in sports medicine. Further understanding of the anatomy and biomechanics of the anterolateral ligament can play a guiding significance for the recovery of knee joint rotational stability.OBJECTIVE: To systematically review current literature on the anterolateral ligament of the knee and to understand the incidence, anatomy, morphology and histology of the anterolateral ligament as well as mechanism of anterolateral ligament injury. METHODS: The first author searched the PubM ed, Medline, CNKI, Wanfang, VIP databases for articles specifically addressing the anterolateral ligament. Data extraction related to the incidence, anatomy, morphometry, biomechanics, and histology of the anterolateral ligament and its relation to the "Segond" fracture was performed. The retrieve time ranged from 1878 to 2015. Totally 362 literatures were retrieved, including 342 articles in English and 20 in Chinese. According to inclusive and exclusive criteria, 42 articles were included in result analysis. RESULTS AND CONCLUSION: The occurrence rate of the anterolateral ligament ranges from 83% to 100%, and this range occurs because of small discrepancies in the definition of the bony insertions of the anterolateral ligament. The anterolateral ligament originates anterior and distal to the femoral attachment of the lateral collateral ligament. It spans the joint in an oblique fashion and inserts between the fibular head and Gerdy tubercle of the tibia. Exact anatomic and morphometric descriptions vary in the literature, and there are discrepancies regarding the anterolateral ligament attachment to the capsule and lateral meniscus. The anterolaterial ligament is a contributor to the stability of tibial internal rotation, and histologically, it exhibits parallel, crimped fibers consistent with a ligamentous microstructure. The footprint of the anterolateral ligament has been shown to be at the exact location of the Segond fracture. The a