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So let's talk formally about the antola ligament.

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The, uh, the

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terminology about this ligament is somewhat confusing.

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Um, and just to give you a brief history,

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it was originally described in 2007 by Vira

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and described just as the a LL.

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But about five years later, another group by Vincent

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basically said that we're talking about the same ligament.

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The A LL is the mid third lateral capsular ligament.

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But this was popularized, um, in 2013 by this article

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by clays this anatomic description

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where they described this a LL

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and unfortunately described it

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as a newly discovered ligament.

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And the lab press sort of ran with it, thinking that, uh,

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we had not known about this ligament for thousands of years,

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but when in fact this is the same thing

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that we have known about the mid third

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lateral capsular ligament.

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But we can identify it on MRI.

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And this is again, how the lateral gict vessels can be a

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nice useful landmark for looking

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for this specific ligament instead

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of the superior lateral canicula vessels.

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This is the inferior lateral gen vessels

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and again, red for artery.

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And we have two paired veins

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and we can see this ligament basically surrounding this

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peripheral, uh, mid body of the lateral meniscus.

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And here from this clay article two, they can,

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they show these, um,

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vessels traveling within the ant lateral ligament,

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basically hugging the periphery of the body

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of the lateral meniscus.

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So here I provide with you a couple of different, uh,

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different, uh, examples of the an lateral ligament.

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Here's a patient who actually presented with insidious, uh,

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lateral knee pain, no history of specific injury,

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and she actually had aral insufficiency fracture.

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And Dr. Resnick showed some fairly nice examples of this.

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You can see the extended bone marrow p uh, edema pattern,

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and you can see this focal thickening

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of the subc chondral bone plate reflecting the presence

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of this insufficiency fracture.

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Again, no specific injury,

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but the reactive soft tissue edema about the lateral aspect

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of the knee does afford us the ability

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to visualize the ant lateral ligament, again,

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surrounding those lateral inferior gict vessels.

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Here's a patient who, uh, suffered a basketball injury

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and here you can see fibers of the ant,

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lateral ligament inferiorly, a little bit thickened, uh,

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and emus and also,

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and its peripheral attachments to lateral meniscus.

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A little bit thickened, but overall no gross

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disruption or discontinuity.

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So this is more of a ligamentous sprain.

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Another patient, uh, juujitsu injury.

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If we look at the superior fibers, we can see

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that they're clearly disrupted

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and even sort of rolled up on, on themselves,

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whereas the inferior

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or meniscal tibial component remains intact.

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If we, uh, move to onto this last example of a patient

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with a BA basketball injury injury, similar findings, again,

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find those lateral inferior gent vessels

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and you can find the peripheral, uh, meniscal tibial portion

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of that ant lateral ligament.

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And if we move up superiorly, we can see

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that it's disrupted from its femoral attach.