The Kaplan fibers are the deep attachments of the iliotibial band to the distal lateral femur, distinct from the main IT band tibial insertion at Gerdy's tubercle. They consist of proximal and distal bundles running from the lateral distal femoral metaphysis, near the lateral intermuscular septum, to the deep surface of the IT band. Together with the anterolateral ligament and lateral capsule they form the anterolateral complex of the knee, providing rotational stability.
| Origin | Deep surface of the distal iliotibial band |
|---|---|
| Insertion | Distal lateral femur at the lateral supracondylar region |
Provide rotational stability to the lateral knee by connecting the femur to the IT band, creating a dynamic restraint to internal tibial rotation especially at low flexion angles.
The Kaplan fibers are a key part of the anterolateral complex alongside the anterolateral ligament (ALL). Combined ACL and anterolateral complex injuries produce a high-grade pivot shift, and isolated ACL reconstruction may leave residual rotational instability if the Kaplan fibers and lateral capsular structures are not addressed. Their injury may be seen on MRI as discontinuity or oedema near the distal femoral metaphysis. Lateral extra-articular tenodesis (LET) and anterolateral ligament reconstruction target this region to augment ACL reconstruction in high-grade pivot shift injuries.
Disruption of the Kaplan fibers with ACL injury produces a high-grade pivot shift from combined anteroposterior and rotational instability; combined ACL reconstruction with lateral extra-articular tenodesis or anterolateral ligament reconstruction addresses the Kaplan fiber deficit to restore both anterior and rotational knee stability.
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