Skip to main content
Top
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 1/2020

01-01-2020 | Ankle

The anterior tibiofibular ligament has a constant distal fascicle that contacts the anterolateral part of the talus

Authors: Miki Dalmau-Pastor, F. Malagelada, G. M. M. J. Kerkhoffs, J. Karlsson, M. C. Manzanares, J. Vega

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 1/2020

Login to get access

Abstract

Purpose

The anterior tibiofibular ligament (ATiFL) and its distal fascicle have been the subject of numerous studies, mainly due to the involvement of this ligament in anterolateral soft-tissue impingement of the ankle. There is currently no firm evidence related to the incidence of the distal fascicle or the frequency with which it is in contact with the talus, or whether this is a constant anatomic finding. In addition, the terminology used to refer to this structure is not accurate and varies widely in previous studies. The purpose of this study was to perform an anatomic study on a large number of specimens to clarify the anatomy of the anterior tibiofibular ligament, and specifically its distal fascicle, and its possible role in anterior ankle impingement syndrome.

Methods

During a 7-year period (2010–2016), cadaveric ankle specimens dissected at our Anatomy Department were included in this study, accounting for a total of 154 ankles. The incidence of the distal fascicle and its contact with the talus were documented.

Results

One hundred and seventeen ankles were included [78 men, 39 women, with a median age of 79.3 years (range 51–100 years)]. The ATiFL was found to have a distal fascicle in 100% of ankles, contacting the anterolateral part of the talus in all cases. The contact was increased in plantarflexion and reduced in dorsiflexion and finally disappeared completely in maximum dorsiflexion.

Conclusions

The ATiFL has a constant distal fascicle that is in contact with the talus in the neutral position and in plantar flexion. Contact disappears in maximum dorsiflexion.
Literature
1.
go back to reference Bassett FH, Gates HS, Billys JB, Morris HB, Nikolaou PK (1990) Talar impingement by the anteroinferior tibiofibular ligament. A cause of chronic pain in the ankle after inversion sprain. J Bone Jt Surg Am 72:55–59CrossRef Bassett FH, Gates HS, Billys JB, Morris HB, Nikolaou PK (1990) Talar impingement by the anteroinferior tibiofibular ligament. A cause of chronic pain in the ankle after inversion sprain. J Bone Jt Surg Am 72:55–59CrossRef
2.
go back to reference Van Den Bekerom MPJ, Raven EEJ (2007) The distal fascicle of the anterior inferior tibiofibular ligament as a cause of tibiotalar impingement syndrome: a current concepts review. Knee Surg Sport Traumatol Arthrosc 15:465–471CrossRef Van Den Bekerom MPJ, Raven EEJ (2007) The distal fascicle of the anterior inferior tibiofibular ligament as a cause of tibiotalar impingement syndrome: a current concepts review. Knee Surg Sport Traumatol Arthrosc 15:465–471CrossRef
3.
go back to reference Nikolopoulos C (1982) Anterolateral instability of the ankle joint: an anatomical, experimental, and clinical study. Ph.D. Thesis, University of Athens Nikolopoulos C (1982) Anterolateral instability of the ankle joint: an anatomical, experimental, and clinical study. Ph.D. Thesis, University of Athens
4.
go back to reference Nikolopoulos CE (2004) The accessory anteroinferior tibiofibular ligament as a cause of talar impingement: a cadaveric study. Am J Sports Med 32:389–395CrossRef Nikolopoulos CE (2004) The accessory anteroinferior tibiofibular ligament as a cause of talar impingement: a cadaveric study. Am J Sports Med 32:389–395CrossRef
5.
go back to reference Subhas N, Vinson EN, Cothran RL, Santangelo JR, Nunley JA, Helms CA (2008) MRI appearance of surgically proven abnormal accessory anterior-inferior tibiofibular ligament (Bassett’s ligament). Skelet Radiol 37:27–33CrossRef Subhas N, Vinson EN, Cothran RL, Santangelo JR, Nunley JA, Helms CA (2008) MRI appearance of surgically proven abnormal accessory anterior-inferior tibiofibular ligament (Bassett’s ligament). Skelet Radiol 37:27–33CrossRef
6.
go back to reference Yeo ED, Rhyu IJ, Kim HJ, Kim DS, Ahn JH, Lee YK (2016) Can Bassett’s ligament be removed? Knee Surg Sport Traumatol Arthrosc 24(4):1236–1242CrossRef Yeo ED, Rhyu IJ, Kim HJ, Kim DS, Ahn JH, Lee YK (2016) Can Bassett’s ligament be removed? Knee Surg Sport Traumatol Arthrosc 24(4):1236–1242CrossRef
7.
go back to reference Akseki D, Pinar H, Bozkurt M, Yaldiz K, Araç S (1999) The distal fascicle of the anterior inferior tibio-fibular ligament as a cause of anterolateral ankle impingement. Acta Orthop Scand 70:478–482CrossRef Akseki D, Pinar H, Bozkurt M, Yaldiz K, Araç S (1999) The distal fascicle of the anterior inferior tibio-fibular ligament as a cause of anterolateral ankle impingement. Acta Orthop Scand 70:478–482CrossRef
8.
go back to reference Akseki D, Pinar H, Yaldiz K, Akseki NG, Arman C (2002) The anterior inferior tibiofibular ligament and talar impingement: a cadaveric study. KSSTA 10:321–326 Akseki D, Pinar H, Yaldiz K, Akseki NG, Arman C (2002) The anterior inferior tibiofibular ligament and talar impingement: a cadaveric study. KSSTA 10:321–326
9.
go back to reference Bartoníček J (2003) Anatomy of the tibiofibular syndesmosis and its clinical relevance. Surg Radiol Anat 25:379–386CrossRef Bartoníček J (2003) Anatomy of the tibiofibular syndesmosis and its clinical relevance. Surg Radiol Anat 25:379–386CrossRef
10.
go back to reference Boonthathip M, Chen L, Trudell DJ, Resnick DL (2010) Tibiofibular syndesmotic ligaments: MR arthrography in cadavers with anatomic correlation. Radiology 254:827–836CrossRef Boonthathip M, Chen L, Trudell DJ, Resnick DL (2010) Tibiofibular syndesmotic ligaments: MR arthrography in cadavers with anatomic correlation. Radiology 254:827–836CrossRef
11.
go back to reference Ebraheim NA, Taser F, Shafiq Q, Yeasting RA (2006) Anatomical evaluation and clinical importance of the tibiofibular syndesmosis ligaments. Surg Radiol Anat 28:142–149CrossRef Ebraheim NA, Taser F, Shafiq Q, Yeasting RA (2006) Anatomical evaluation and clinical importance of the tibiofibular syndesmosis ligaments. Surg Radiol Anat 28:142–149CrossRef
12.
go back to reference Ray RG, Kriz BM (1991) Anterior inferior tibiofibular ligament. Variations and relationship to the talus. J Am Podiatr Med Assoc 81:479–485CrossRef Ray RG, Kriz BM (1991) Anterior inferior tibiofibular ligament. Variations and relationship to the talus. J Am Podiatr Med Assoc 81:479–485CrossRef
13.
go back to reference Hermans JJ, Beumer A, De Jong TAW, Kleinrensink GJ (2010) Anatomy of the distal tibiofibular syndesmosis in adults: a pictorial essay with a multimodality approach. J Anat 217:633–645CrossRef Hermans JJ, Beumer A, De Jong TAW, Kleinrensink GJ (2010) Anatomy of the distal tibiofibular syndesmosis in adults: a pictorial essay with a multimodality approach. J Anat 217:633–645CrossRef
14.
go back to reference Jacobson K, Ng A, Haffner KE (2011) Arthroscopic treatment of anterior ankle impingement. Clin Podiatr Med Surg 28:491–510CrossRef Jacobson K, Ng A, Haffner KE (2011) Arthroscopic treatment of anterior ankle impingement. Clin Podiatr Med Surg 28:491–510CrossRef
15.
go back to reference Dalmau-Pastor M, Vega J (2017) Letter regarding: cadaveric analysis of the distal tibiofibular syndesmosis. Foot Ankle Int 38:343–345CrossRef Dalmau-Pastor M, Vega J (2017) Letter regarding: cadaveric analysis of the distal tibiofibular syndesmosis. Foot Ankle Int 38:343–345CrossRef
16.
go back to reference Federative Committee on Anatomical Terminology (1998) International Anatomical Terminology. Thieme, Stuttgart Federative Committee on Anatomical Terminology (1998) International Anatomical Terminology. Thieme, Stuttgart
17.
go back to reference Golanó P, Vega J, Pérez-Carro L, Götzens V (2006) Ankle anatomy for the arthroscopist. Part II: role of the ankle ligaments in soft tissue impingement. Foot Ankle Clin 11:275–296CrossRef Golanó P, Vega J, Pérez-Carro L, Götzens V (2006) Ankle anatomy for the arthroscopist. Part II: role of the ankle ligaments in soft tissue impingement. Foot Ankle Clin 11:275–296CrossRef
18.
go back to reference Vega J, Dalmau-Pastor M, Malagelada F, Fargues-Polo B, Peña F (2017) Ankle arthroscopy: an update. J Bone Jt Surg 99:1395–1407CrossRef Vega J, Dalmau-Pastor M, Malagelada F, Fargues-Polo B, Peña F (2017) Ankle arthroscopy: an update. J Bone Jt Surg 99:1395–1407CrossRef
19.
go back to reference Rasmussen O, Tovborg-Jensen IB, Boe S (1982) Distal tibiofibular ligaments. Acta Orthop Scand 53:681–686CrossRef Rasmussen O, Tovborg-Jensen IB, Boe S (1982) Distal tibiofibular ligaments. Acta Orthop Scand 53:681–686CrossRef
20.
go back to reference Caputo AM, Lee JY, Spritzer CE, Easley ME, Deorio JK, Ii JAN, Defrate LE, Carolina N (2009) In vivo kinematics of the tibiotalar joint after lateral ankle instability. Am J Sports Med 37:2241–2248CrossRef Caputo AM, Lee JY, Spritzer CE, Easley ME, Deorio JK, Ii JAN, Defrate LE, Carolina N (2009) In vivo kinematics of the tibiotalar joint after lateral ankle instability. Am J Sports Med 37:2241–2248CrossRef
21.
go back to reference Vega J, Peña F, Golanó P (2016) Minor or occult ankle instability as a cause of anterolateral pain after ankle sprain. Knee Surg Sport Traumatol Arthrosc 24(4):1116–1123CrossRef Vega J, Peña F, Golanó P (2016) Minor or occult ankle instability as a cause of anterolateral pain after ankle sprain. Knee Surg Sport Traumatol Arthrosc 24(4):1116–1123CrossRef
22.
go back to reference Katz JN, Barrett J, Mahomed NN, Baron JA, Wright RJ, Losina E (2004) Association between hospital and surgeon procedure volume and the outcomes of total knee replacement. J Bone Jt Surg Am 86–A:1909–1916CrossRef Katz JN, Barrett J, Mahomed NN, Baron JA, Wright RJ, Losina E (2004) Association between hospital and surgeon procedure volume and the outcomes of total knee replacement. J Bone Jt Surg Am 86–A:1909–1916CrossRef
23.
go back to reference Lau RL, Perruccio AV, Gandhi R, Mahomed NN (2012) The role of surgeon volume on patient outcome in total knee arthroplasty: a systematic review of the literature. BMC Musculoskelet Disord 13:250CrossRef Lau RL, Perruccio AV, Gandhi R, Mahomed NN (2012) The role of surgeon volume on patient outcome in total knee arthroplasty: a systematic review of the literature. BMC Musculoskelet Disord 13:250CrossRef
24.
go back to reference McAteer JP, LaRiviere CA, Drugas GT, Abdullah F, Oldham KT, Goldin AB (2013) Influence of surgeon experience, hospital volume, and specialty designation on outcomes in pediatric surgery. JAMA Pediatr 167:468–475CrossRef McAteer JP, LaRiviere CA, Drugas GT, Abdullah F, Oldham KT, Goldin AB (2013) Influence of surgeon experience, hospital volume, and specialty designation on outcomes in pediatric surgery. JAMA Pediatr 167:468–475CrossRef
25.
go back to reference Pennington N, Redmond A, Stewart T, Stone M (2014) The impact of surgeon handedness in total hip replacement. Ann R Coll Surg Engl 96:437–441CrossRef Pennington N, Redmond A, Stewart T, Stone M (2014) The impact of surgeon handedness in total hip replacement. Ann R Coll Surg Engl 96:437–441CrossRef
Metadata
Title
The anterior tibiofibular ligament has a constant distal fascicle that contacts the anterolateral part of the talus
Authors
Miki Dalmau-Pastor
F. Malagelada
G. M. M. J. Kerkhoffs
J. Karlsson
M. C. Manzanares
J. Vega
Publication date
01-01-2020
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 1/2020
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-018-5123-z

Other articles of this Issue 1/2020

Knee Surgery, Sports Traumatology, Arthroscopy 1/2020 Go to the issue