{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T10:55:04Z","timestamp":1764240904452,"version":"3.46.0"},"reference-count":33,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T00:00:00Z","timestamp":1763942400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001871","name":"National Funds Through FCT\u2014Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia","doi-asserted-by":"publisher","award":["UIDB\/4255\/2020","LA\/P\/0053\/2020"],"award-info":[{"award-number":["UIDB\/4255\/2020","LA\/P\/0053\/2020"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: This study aims to describe in detail the previously reported close relationship between the anterolateral ligament (ALL) and the lateral meniscus. Few previous studies identified and characterized this relation. This study further characterizes the anatomical relation between the ALL and the lateral meniscus through meticulous cadaveric dissection. Methods: A total of 31 cadaver knees were dissected. The ALL relation with the lateral meniscus was explored using a specific dissection protocol that involved removing the central pivot (cruciate ligaments) and medial structures of the knee to enhance visualization of the anterolateral complex. The zone and attachment pattern of the ALL on the lateral meniscus were recorded. Results: The ALL was found in all 31 dissected knees and in all cases has an attachment to the lateral meniscus. It was attached in zone 2b of the lateral meniscus in 97% of cases. The median anteroposterior length of attachment of the ALL on the lateral meniscus was 6 mm (25th and 75th percentiles of 5\u20137 mm). Almost 80% (77.4%) of ALL attachments on the lateral meniscus were full thickness or bipolar (superior and inferior margins). In the remaining knees, the ALL was fixed only in the upper part (4 knees, 12.9%) or only in the lower part (3 knees, 9.7%) of the lateral meniscus. Conclusions: The ALL has an attachment to the lateral meniscus in all studied knees, with its most prevalent site at zone 2b. The most frequent types of ALL attachment on the lateral meniscus were full thickness or bipolar. These anatomic insights support targeted anterolateral augmentation and meniscal preservation to optimize clinical results.<\/jats:p>","DOI":"10.3390\/diagnostics15232987","type":"journal-article","created":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T08:50:20Z","timestamp":1764060620000},"page":"2987","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Anatomical Insights into the Lateral Meniscus and Anterolateral Ligament: A Cadaveric Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7085-6926","authenticated-orcid":false,"given":"Jo\u00e3o","family":"Lobo","sequence":"first","affiliation":[{"name":"Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Alameda Professor Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"},{"name":"Orthopedics and Traumatology Department, Unidade Local Saude S\u00e3o Jo\u00e3o, Alameda Professor Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"}]},{"given":"Joana","family":"Almeida","sequence":"additional","affiliation":[{"name":"Orthopedics and Traumatology Department, Unidade Local Saude S\u00e3o Jo\u00e3o, Alameda Professor Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"}]},{"given":"Jos\u00e9","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Orthopedics and Traumatology Department, Unidade Local Saude S\u00e3o Jo\u00e3o, Alameda Professor Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"}]},{"given":"H\u00e9lio","family":"Alves","sequence":"additional","affiliation":[{"name":"Unit of Anatomy, Department of Biomedicine, Faculty of Medicine, University of Porto, Alameda Professor Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"}]},{"given":"Andr\u00e9 Rodrigues","family":"Pinho","sequence":"additional","affiliation":[{"name":"Orthopedics and Traumatology Department, Unidade Local Saude S\u00e3o Jo\u00e3o, Alameda Professor Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"},{"name":"Unit of Anatomy, Department of Biomedicine, Faculty of Medicine, University of Porto, Alameda Professor Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"},{"name":"NeuroGen Research Group, Center for Health Technology and Services Research (CINTESIS), Rua Dr. Pl\u00e1cido da Costa, 4200-450 Porto, Portugal"},{"name":"CINTESIS@RISE, Faculty of Medicine, University of Porto, Alameda Professor Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0721-6547","authenticated-orcid":false,"given":"Maria Dulce","family":"Madeira","sequence":"additional","affiliation":[{"name":"Unit of Anatomy, Department of Biomedicine, Faculty of Medicine, University of Porto, Alameda Professor Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"},{"name":"NeuroGen Research Group, Center for Health Technology and Services Research (CINTESIS), Rua Dr. Pl\u00e1cido da Costa, 4200-450 Porto, Portugal"},{"name":"CINTESIS@RISE, Faculty of Medicine, University of Porto, Alameda Professor Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"}]},{"given":"Levi Reina","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Hospital CUF Santar\u00e9m, Rua Zeferino Silva 39 a 51, 2005-321 Santar\u00e9m, Portugal"}]},{"given":"Ana","family":"Esteves","sequence":"additional","affiliation":[{"name":"Orthopedics and Traumatology Department, Unidade Local Saude do T\u00e2mega e Sousa, Avenida do Hospital Padre Am\u00e9rico, No. 210, 4560-136 Guilhufe, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2298-3143","authenticated-orcid":false,"given":"Pedro Alberto","family":"Pereira","sequence":"additional","affiliation":[{"name":"Unit of Anatomy, Department of Biomedicine, Faculty of Medicine, University of Porto, Alameda Professor Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"},{"name":"NeuroGen Research Group, Center for Health Technology and Services Research (CINTESIS), Rua Dr. Pl\u00e1cido da Costa, 4200-450 Porto, Portugal"},{"name":"CINTESIS@RISE, Faculty of Medicine, University of Porto, Alameda Professor Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,24]]},"reference":[{"key":"ref_1","first-page":"297","article-title":"Recherches cliniques et experimentales sur les \u00e9panchements sanguins du genou par entorse","volume":"7","author":"Segond","year":"1879","journal-title":"Prog. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1055\/s-0030-1248172","article-title":"Anatomy and biomechanics of the posterolateral corner of the knee","volume":"18","author":"Moorman","year":"2005","journal-title":"J. Knee Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1007\/s00167-011-1580-3","article-title":"The anterolateral ligament of the human knee: An anatomic and histologic study","volume":"20","author":"Vincent","year":"2012","journal-title":"Knee Surg. Sports Traumatol. Arthrosc."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1007\/s00167-016-4349-x","article-title":"Historical perspective on the \u201cdiscovery\u201d of the anterolateral ligament of the knee","volume":"25","author":"Cavaignac","year":"2017","journal-title":"Knee Surg. Sports Traumatol. Arthrosc."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1111\/joa.12087","article-title":"Anatomy of the anterolateral ligament of the knee","volume":"223","author":"Claes","year":"2013","journal-title":"J. Anat."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1007\/s00167-015-3913-0","article-title":"Anterolateral ligament of the knee, fact or fiction?","volume":"24","author":"Musahl","year":"2016","journal-title":"Knee Surg. Sports Traumatol. Arthrosc."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/j.csm.2017.07.013","article-title":"What Is the State of the Evidence in Anterolateral Ligament Research?","volume":"37","author":"Moroz","year":"2018","journal-title":"Clin. Sports Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1007\/s10195-017-0449-8","article-title":"Anterolateral Ligament Expert Group consensus paper on the management of internal rotation and instability of the anterior cruciate ligament\u2014deficient knee","volume":"18","author":"Daggett","year":"2017","journal-title":"J. Orthop. Traumatol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"3186","DOI":"10.1007\/s00167-014-3117-z","article-title":"A cadaveric study of the anterolateral ligament: Re-introducing the lateral capsular ligament","volume":"23","author":"Caterine","year":"2015","journal-title":"Knee Surg. Sports Traumatol. Arthrosc."},{"key":"ref_10","first-page":"134","article-title":"Anterolateral ligament of the knee-Cadaver study in a Caucasian population","volume":"67","author":"Fernandes","year":"2023","journal-title":"Rev. Esp. Cir. Ortop. Traumatol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2083","DOI":"10.1007\/s00167-014-3422-6","article-title":"Anatomic description of the anterolateral ligament of the knee","volume":"24","author":"Stijak","year":"2016","journal-title":"Knee Surg. Sports Traumatol. Arthrosc."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1606","DOI":"10.1177\/0363546515578253","article-title":"The Anterolateral Ligament: An Anatomic, Radiographic, and Biomechanical Analysis","volume":"43","author":"Kennedy","year":"2015","journal-title":"Am. J. Sports Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2325967117708190","DOI":"10.1177\/2325967117708190","article-title":"The Role of the Peripheral Passive Rotation Stabilizers of the Knee with Intact Collateral and Cruciate Ligaments: A Biomechanical Study","volume":"5","author":"Vap","year":"2017","journal-title":"Orthop. J. Sports Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1669","DOI":"10.1177\/0363546514532336","article-title":"Extra-articular ACL Reconstruction and Pivot Shift: In Vivo Dynamic Evaluation With Navigation","volume":"42","author":"Monaco","year":"2014","journal-title":"Am. J. Sports Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1002\/ca.22456","article-title":"The human meniscus: A review of anatomy, function, injury, and advances in treatment","volume":"28","author":"Fox","year":"2015","journal-title":"Clin. Anat."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1288","DOI":"10.1016\/j.arthro.2023.09.031","article-title":"The Anterolateral Ligament of the Knee Is a Nonisometric Thin Ligament with High Prevalence and Almost Constant Attachment to the Lateral Meniscus: A Systematic Review with Meta-analysis","volume":"40","author":"Totlis","year":"2024","journal-title":"Arthroscopy"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1007\/s00276-015-1533-5","article-title":"The meniscal insertion of the knee anterolateral ligament","volume":"38","author":"Helito","year":"2016","journal-title":"Surg. Radiol. Anat."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1002\/ca.22222","article-title":"From formalin to Thiel embalming: What changes? One anatomy department\u2019s experiences","volume":"26","author":"Eisma","year":"2013","journal-title":"Clin. Anat."},{"unstructured":"Loukas, M., Tubbs, R.S., and Benninger, B. (2019). Gray\u2019s Clinical Photographic Dissector of the Human Body, Elsevier. [2nd ed.].","key":"ref_19"},{"unstructured":"Standring, S. (2021). Gray\u2019s Anatomy\u2014The Anatomical Basis of Clinical Practice, Elsevier. [42nd ed.].","key":"ref_20"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1007\/s12178-022-09768-1","article-title":"Review of Meniscus Anatomy and Biomechanics","volume":"15","author":"Mameri","year":"2022","journal-title":"Curr. Rev. Musculoskelet. Med."},{"doi-asserted-by":"crossref","unstructured":"Cho, H.J., and Kwak, D.S. (2019). Anatomical Consideration of the Anterolateral Ligament of the Knee. Biomed. Res. Int., 2019.","key":"ref_22","DOI":"10.1155\/2019\/5740473"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1007\/s00402-016-2617-3","article-title":"Anatomic dissection of the anterolateral ligament (ALL) in paired fresh-frozen cadaveric knee joints","volume":"137","author":"Roessler","year":"2017","journal-title":"Arch. Orthop. Trauma. Surg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1590\/1413-785220172502162204","article-title":"Study of the anterolateral ligament of the knee in formalin\u2014Embedded cadavers","volume":"25","author":"Fardin","year":"2017","journal-title":"Acta Ortop. Bras."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e51","DOI":"10.1097\/BPO.0000000000000616","article-title":"The Anterolateral Ligament of the Knee: An Inconsistent Finding in Pediatric Cadaveric Specimens","volume":"36","author":"Shea","year":"2016","journal-title":"J. Pediatr. Orthop."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1016\/j.rbo.2013.04.003","article-title":"Anatomical study on the anterolateral ligament of the knee","volume":"48","author":"Helito","year":"2013","journal-title":"Rev. Bras. Ortop."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1647","DOI":"10.1007\/s00256-015-2218-1","article-title":"Characterization of the anatomy of the anterolateral ligament of the knee using magnetic resonance imaging","volume":"44","author":"Kosy","year":"2015","journal-title":"Skelet. Radiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1007\/s00167-011-1640-8","article-title":"Navigated knee kinematics after cutting of the ACL and its secondary restraint","volume":"20","author":"Monaco","year":"2012","journal-title":"Knee Surg. Sports Traumatol. Arthrosc."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"2325967114562205","DOI":"10.1177\/2325967114562205","article-title":"Evaluation of the Length and Isometric Pattern of the Anterolateral Ligament with Serial Computer Tomography","volume":"2","author":"Helito","year":"2014","journal-title":"Orthop. J. Sports Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2325967113513546","DOI":"10.1177\/2325967113513546","article-title":"Anatomy and Histology of the Knee Anterolateral Ligament","volume":"1","author":"Helito","year":"2013","journal-title":"Orthop. J. Sports Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2128","DOI":"10.1177\/0363546512449994","article-title":"Meniscal and chondral injuries associated with pediatric anterior cruciate ligament tears: Relationship of treatment time and patient-specific factors","volume":"40","author":"Dumont","year":"2012","journal-title":"Am. J. Sports Med."},{"key":"ref_32","first-page":"45","article-title":"High prevalence of anterolateral ligament abnormalities in magnetic resonance images of anterior cruciate ligament-injured knees","volume":"80","author":"Claes","year":"2014","journal-title":"Acta Orthop. Belg."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1136","DOI":"10.1177\/03635465231161071","article-title":"Role of the Anterior Cruciate Ligament, Anterolateral Complex, and Lateral Meniscus Posterior Root in Anterolateral Rotatory Knee Instability: A Biomechanical Study","volume":"51","author":"Willinger","year":"2023","journal-title":"Am. J. Sports Med."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/23\/2987\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T10:45:11Z","timestamp":1764240311000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/23\/2987"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,24]]},"references-count":33,"journal-issue":{"issue":"23","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["diagnostics15232987"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics15232987","relation":{},"ISSN":["2075-4418"],"issn-type":[{"type":"electronic","value":"2075-4418"}],"subject":[],"published":{"date-parts":[[2025,11,24]]}}}