This 1986 cadaveric dissection study by Terry, Hughston, and Norwood systematically describes the five-layer anatomy of the lateral fascia lata at the knee. It defines two functional components — the iliopatellar band and the iliotibial tract — and introduces the concept that three layers of the iliotibial tract together constitute an anterolateral ligament.
The pivot shift in an ACL-deficient knee is not purely an ACL problem. This paper establishes that anterolateral stability depends on the combined integrity of the ACL, mid-third capsular ligament, lateral meniscus, and the deep/capsulo-osseous layers of the iliotibial tract.
When a patient has a high-grade pivot shift out of proportion to their ACL injury, think about concomitant lateral structure injury. This anatomy explains why some ACL reconstructions fail to abolish the pivot shift and why lateral extraarticular procedures are added.
In the OR, recognize that the capsulo-osseous layer inserts posterior to Gerdy's tubercle — not at it. Preserving this layer during lateral approaches protects anterolateral stability.
This paper is foundational to understanding the modern anterolateral ligament (ALL) debate. The 'anterolateral ligament' described in 2013 by Claes et al. Corresponds directly to the anatomy Terry described here in 1986.
This 1986 cadaveric dissection study by Terry, Hughston, and Norwood systematically describes the five-layer anatomy of the lateral fascia lata at the knee. It defines two functional components — the iliopatellar band and the iliotibial tract — and introduces the concept that three layers of the iliotibial tract together constitute an anterolateral ligament.
The pivot shift in an ACL-deficient knee is not purely an ACL problem. This paper establishes that anterolateral stability depends on the combined integrity of the ACL, mid-third capsular ligament, lateral meniscus, and the deep/capsulo-osseous layers of the iliotibial tract.
When a patient has a high-grade pivot shift out of proportion to their ACL injury, think about concomitant lateral structure injury. This anatomy explains why some ACL reconstructions fail to abolish the pivot shift and why lateral extraarticular procedures are added.
In the OR, recognize that the capsulo-osseous layer inserts posterior to Gerdy's tubercle — not at it. Preserving this layer during lateral approaches protects anterolateral stability.
This paper is foundational to understanding the modern anterolateral ligament (ALL) debate. The 'anterolateral ligament' described in 2013 by Claes et al. Corresponds directly to the anatomy Terry described here in 1986.