This cadaveric study asks whether the structure Segond described in 1879 as a 'pearly, fibrous band' at the anterolateral knee is a real, distinct ligament. The authors dissected 41 unpaired human knees to define its origin, insertion, course, and neighboring relationships. They aimed to resolve a century of inconsistent naming for this structure, now termed the anterolateral ligament (ALL).
This is the anatomical foundation behind the modern interest in anterolateral procedures for rotational knee instability. The key mental model: the Segond fracture is a bony avulsion of the ALL at its anterolateral tibial insertion. When you see a Segond fracture on X-ray, think ACL tear, and now also think ALL injury contributing to the pivot shift.
Surgically, three relationships matter. The origin sits just anterior to the LCL on the epicondyle. The course crosses over the lateral meniscus and envelops the lateral inferior geniculate vessels. The tibial insertion is distinct from the ITB, midway between Gerdy's tubercle and the fibular head.
Weight the evidence appropriately. This is a cadaveric anatomic study in elderly specimens (mean age 79) that defines structure, not function. The role in controlling internal rotation is a hypothesis the authors explicitly flag as needing kinematic confirmation. Understand these landmarks before evaluating or performing ALL reconstruction as an adjunct to ACL surgery.
This cadaveric study asks whether the structure Segond described in 1879 as a 'pearly, fibrous band' at the anterolateral knee is a real, distinct ligament. The authors dissected 41 unpaired human knees to define its origin, insertion, course, and neighboring relationships. They aimed to resolve a century of inconsistent naming for this structure, now termed the anterolateral ligament (ALL).
This is the anatomical foundation behind the modern interest in anterolateral procedures for rotational knee instability. The key mental model: the Segond fracture is a bony avulsion of the ALL at its anterolateral tibial insertion. When you see a Segond fracture on X-ray, think ACL tear, and now also think ALL injury contributing to the pivot shift.
Surgically, three relationships matter. The origin sits just anterior to the LCL on the epicondyle. The course crosses over the lateral meniscus and envelops the lateral inferior geniculate vessels. The tibial insertion is distinct from the ITB, midway between Gerdy's tubercle and the fibular head.
Weight the evidence appropriately. This is a cadaveric anatomic study in elderly specimens (mean age 79) that defines structure, not function. The role in controlling internal rotation is a hypothesis the authors explicitly flag as needing kinematic confirmation. Understand these landmarks before evaluating or performing ALL reconstruction as an adjunct to ACL surgery.