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New ligament discovered in the knee!

post #1 of 14
Thread Starter 

Apparently a new ligament has been discovered in the knee joint! It's called the anterolateral ligament (ALL) and has been cited over the past 10ish hours by a few sources. It will be interesting to see the implications of the ALL in ACL/MCL tearing and rehabilitation. 

 

Even more links:

 

http://www.medicaldaily.com/new-body-part-discovered-human-knee-research-ids-anterolateral-ligament-proves-1879-french-surgeon

 

http://www.huffingtonpost.com/2013/11/06/new-ligament-human-knee-anterolateral_n_4221043.html

post #2 of 14

I saw that this morning, very cool. Interesting that the first hypothesis mentioning its existence was from 1879.

post #3 of 14

I don't know about anyone else but that is an important discovery for me!  I have an old ACL injury which prevents me from many activities without a brace.   I bet the ALL was damaged with my ACL, I like to know what side of the knee the ALL is connected, all my ligaments on the inside of my right knee was torn as well. (it folded sideways)  If the ALL is located on the left side of my right knee, that might explain why my knee will easily pop, shift, or move under certain activities.

 

And the older I am getting the more I feel it.   I know a few other people has had similar injuries and I like to hear their thoughts as well.

post #4 of 14
Quote:
Originally Posted by Becca View Post
 

 I like to know what side of the knee the ALL is connected

Antero = towards the front

 

Lateral = away from midline

 

So "anterolateral" means to the front-outside of the structure (although that cadaver image makes it look fairly lateral where it originates on the femur and it inserts more forward on the tibia).

post #5 of 14

Damm another ligament to tear!!!!

post #6 of 14
post #7 of 14
Quote:
Originally Posted by Toecutter View Post
 

Antero = towards the front

 

Lateral = away from midline

 

So "anterolateral" means to the front-outside of the structure (although that cadaver image makes it look fairly lateral where it originates on the femur and it inserts more forward on the tibia).

 

Thanks Toecutter!   I was trying to figure out how the whole structure was and that helped.   It's to late for me but if it helps other not suffering like I have, AWESOME.

post #8 of 14

I was also skeptical after my initial "cool!" reaction and therefore dug out my old college anatomy book. There was a ligament in there that looked suspiciously like the same one. I should have written it down--I'll dig it out again later.

post #9 of 14
Thread Starter 

 

I'm glad you posted this. I'm appalled that Science Daily and Medical Daily reprinted the article - what a disservice. It just goes to show you that you should only ever cite primary sources. 

post #10 of 14

Magi suggested I check out this thread; I'll link my response in the injuries forum: http://www.epicski.com/t/122943/donjoy-reaction-knee-brace

 

Executive summary: Don't be appalled; not a disservice. 

post #11 of 14
Quote:
Originally Posted by beyond View Post

No rain. :) Thanks for the link. The initial article I read was in the New York Times, which usually is reliable. It links, in turn, to the article in the J Anat, which is highly respected, peer reviewed. Said article noted right away that the structure in question was first described by a French surgeon in the 18th century. And concludes:

 

"By providing a detailed anatomical characterization of the ALL, this study clarifies the long-standing enigma surrounding the existence of a ligamentous structure connecting the femur with the anterolateral tibia. Given its structure and anatomic location, the ALL is hypothesized to control internal tibial rotation and thus to affect the pivot shift phenomenon, although further studies are needed to investigate its biomechanical function." 

 

In other words, the NYT and I were using "discover" in a casual way. In reality, things are seldom literally discovered in science, but on the other hand, a description that differentiates a new entity that was formerly lumped with others, or misunderstood, along with a new functional explanation that's testable, is pretty close. That's more than a re-description. 

 

Modern physics, paleontology, biology, and astronomy provide plenty of obvious examples. Plenty of fossil species have been discovered in material collected years ago, measured, catalogued, and left to collect (more) dust in a museum drawer. A fresh pair of eyes, a more careful set of measurements, a more relevant theory, and whoaah! a new ancestor. Same happens in zoology all the time when one species of say fish is observed carefully, perhaps some DNA is sampled, and discovered to be two species. Einstein didn't deal with much that hadn't been first described in the 19th century. But he provided a set of explanations and testable predictions that reshaped how we interpreted the old data. He was the discoverer of relativity. Watson and Crick weren't the first to describe DNA. By far. But they were the first to look at the descriptions and realize what they were looking at, what the implications were. So the Nobel committee considered them the co-discoverers. 

 

When I taught anatomy, the ALL, if and when we found something that must have been it, was considered to be a normal variant/accessory of the FCL. That is, we didn't see it as having its own function and own evolutionary backstory. We literally didn't see it. The ALL is not indicated in any anatomy text or atlas I own, or am familiar with. So to argue it's actually a new ligament with its own biomechanics is pretty close to a discovery, actually, whatever your link says. ;) 

 

Quote:
Originally Posted by beyond View Post
 

Magi suggested I check out this thread; I'll link my response in the injuries forum: http://www.epicski.com/t/122943/donjoy-reaction-knee-brace

 

Thanks for stopping by Beyond.  :)

 

My problem with the reporting isn't that nothing new was discovered (it was!) is that most of the people who've read the coverage (or just the headline) really do think there was tissue hiding in the body that no one knew was there - and that strikes me as bad reporting. 

 

  "Scientists discover function for ligament!", "Scientists discover new model of knee motion!", or "Scientists discover that previous theory wasn't complete!  Thousands say 'duh'."   All strike me as far more correct (and responsible) ways of reporting this to the public.

 

Its clear to me from articles like this: http://drrobertlaprademd.com/what-is-the-anterolateral-ligament-of-the-knee that surgeons (at least the best ones) have known about this ligament for some time, and while its functional role may be in doubt, we didn't find out people have a secret ligament last week.

 

 

All of that aside - @beyond shed some light on this: It's right next to the FCL, its present in 97% of the population, and no one thought it did anything?  Why the heck did we evolve it in the first place if it's not doing anything?  That reeks of hubris to me (especially in a system as obviously functional as the knee)

post #12 of 14

Does the Kneebinding protect the ALL?;)

post #13 of 14
Quote:
Originally Posted by oldgoat View Post
 

Does the Kneebinding protect the ALL?;)

:popcorn

post #14 of 14

My mom was an RN. She came home from a refresher once and said it was amazing how many body parts had been invented since she finished school.

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