title: Correlation of Magnetic Resonance Imaging With Knee Anterolateral Ligament Anatomy: A Cadaveric Study.
abstract: BACKGROUND
  Anatomic and magnetic resonance imaging (MRI) studies have recently characterized the knee anterolateral ligament (ALL). So far, no study has focused on confirming whether the evaluated MRI parameters truly correspond with ALL anatomy.
  
  
  OBJECTIVE
  To assess the validity of MRI in detecting the ALL using an anatomic evaluation as reference.
  
  
  METHODS
  Descriptive laboratory study.
  
  
  METHODS
  A total of 13 cadaveric knees were subjected to MRI and then to anatomic dissection. Dissection was performed according to previous anatomic study methodology. MRIs were performed with a 0.6- to 1.5-mm slice thickness and prior saline injection. The following variables were analyzed: distance from the origin of the ALL to the origin of the lateral collateral ligament (LCL), distance from the origin of the ALL to its bifurcation point, maximum length of the ALL, distance from the tibial insertion of the ALL to the articular surface of the tibia, ALL thickness, and ALL width. The 2 sets of measurements were analyzed using the Spearman correlation coefficient (ρ) and Bland-Altman plots.
  
  
  RESULTS
  The ALL was clearly observed in all dissected knees and MRI scans. It originated anterior and distal to the LCL, close to the lateral epycondile center, and showed an anteroinferior path toward the tibia, inserting between the Gerdy tubercle and the fibular head, around 5 mm under the lateral plateau. The ρ values tended to increase together for all studied variables between the 2 methods, and all were statistically significant, except for thickness (P = .077). Bland-Altman plots showed a tendency toward a reduction of ALL thickness and width by MRI compared with anatomic dissection.
  
  
  CONCLUSIONS
  MRI scanning as described can accurately assess the ALL and demonstrates characteristics similar to those seen under anatomic dissection.
  
  
  CONCLUSIONS
  MRI can accurately characterize the ALL in the anterolateral region of the knee, despite the presence of structures that might overlap and thus cause confusion when making assessments based on imaging methods.
authors.affiliation: Department of Orthopaedics and Traumatology, Knee Surgery Division, Institute of Orthopedics and Traumatology-Hospital and Clinics, Faculty of Medicine, University of São Paulo (IOT\-HCFMUSP), São Paulo, Brazil.
authors.forename: Camilo Partezani
authors.initials: CP
authors.lastname: Helito
authors.affiliation: Department of Orthopaedics and Traumatology, Musculoskeletal Radiology Division, Institute of Orthopedics and Traumatology-Hospital and Clinics, Faculty of Medicine, University of São Paulo (IOT\-HCFMUSP), São Paulo, Brazil.
authors.forename: Paulo Victor Partezani
authors.initials: PV
authors.lastname: Helito
authors.affiliation: Department of Orthopaedics and Traumatology, Knee Surgery Division, Institute of Orthopedics and Traumatology-Hospital and Clinics, Faculty of Medicine, University of São Paulo (IOT\-HCFMUSP), São Paulo, Brazil.
authors.forename: Marcelo Batista
authors.initials: MB
authors.lastname: Bonadio
authors.affiliation: Department of Orthopaedics and Traumatology, Knee Surgery Division, Institute of Orthopedics and Traumatology-Hospital and Clinics, Faculty of Medicine, University of São Paulo (IOT\-HCFMUSP), São Paulo, Brazil.
authors.forename: José Ricardo
authors.initials: JR
authors.lastname: Pécora
authors.affiliation: Department of Orthopaedics and Traumatology, Musculoskeletal Radiology Division, Institute of Orthopedics and Traumatology-Hospital and Clinics, Faculty of Medicine, University of São Paulo (IOT\-HCFMUSP), São Paulo, Brazil.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Bordalo-Rodrigues
authors.affiliation: Department of Orthopaedics and Traumatology, Knee Surgery Division, Institute of Orthopedics and Traumatology-Hospital and Clinics, Faculty of Medicine, University of São Paulo (IOT\-HCFMUSP), São Paulo, Brazil.
authors.forename: Gilberto Luis
authors.initials: GL
authors.lastname: Camanho
authors.affiliation: Department of Orthopaedics and Traumatology, Knee Surgery Division, Institute of Orthopedics and Traumatology-Hospital and Clinics, Faculty of Medicine, University of São Paulo (IOT\-HCFMUSP), São Paulo, Brazil.
authors.forename: Marco Kawamura
authors.initials: MK
authors.lastname: Demange
keywords: MRI; anatomy; anterolateral ligament; magnetic resonance imaging