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The Anterolateral Ligament: An Anatomic Study on Sex-Based Differences.

Matt Daggett1, Camilo Helito2, Matthew Cullen1

  • 1Kansas City University, Kanas City, Missouri, USA.

Orthopaedic Journal of Sports Medicine
|March 22, 2017
PubMed
Summary

The anterolateral ligament (ALL) is significantly thicker in males than females, potentially explaining higher ACL injury rates and knee instability in female athletes. This study highlights key sex-based anatomical differences in the knee.

Keywords:
anatomyanterior cruciate ligamentanterolateral ligamentanterolateral rotatory instabilitygender differences

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Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Anatomy

Background:

  • The anterolateral ligament (ALL) plays a crucial role in knee rotatory stability.
  • Limited research exists on sex-based differences in the ALL, unlike the anterior cruciate ligament (ACL).

Purpose of the Study:

  • To investigate and define sex-based anatomical differences in the anterolateral ligament (ALL).
  • Specifically, to compare the length, width, and thickness of the ALL between males and females.

Main Methods:

  • A descriptive laboratory study was conducted on 165 unpaired knees.
  • Morphometric measurements (length, width, thickness) of the ALL were taken using digital calipers.
  • Statistical analyses, including Mann-Whitney and Student t-tests, compared measurements between sexes. Pearson correlation assessed the relationship between height/weight and ALL dimensions.

Main Results:

  • The anterolateral ligament (ALL) was found to be significantly thicker in males (2.09 mm) compared to females (1.05 mm) (P < 10⁻¹⁹).
  • Significant differences in ALL length were observed between sexes (P < 10⁻⁶).
  • No significant difference in ALL width was detected between males and females. Moderate correlation found between donor height and ALL thickness/length.

Conclusions:

  • Anatomical measurements reveal significant sex-based differences in the anterolateral ligament (ALL).
  • The ALL is notably thicker in males than in females.
  • These differences may contribute to the higher incidence of ACL ruptures and knee instability observed in female athletes.