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A new knee ligament - could it help skier ACL recovery?

  
  
  

Two Belgian knee surgeons claim to have found a “new” ligament in the knee, called the Anterolateral Ligament(ALL) that could have great implications for the success of ACL reconstruction, one of the most common skier injuries.

acl and skiing

After reading about the new ligament on BBC, I could hardly believe that something as large as a ligament could have escaped the eyes of great surgeons and MRI scans, so I called an old friend, skier, and knee guru, Dr. Gilbert Anderson, to get his perspective. “I’d be surprised if they found a new ligament,” he replied, “but what happens sometimes is they learn to break down a previously known structure into new parts.”

In 1879, a French surgeon named Paul Segond pointed out the potential of such a ligament, but it has been classified more as part of the neighboring Lateral Collateral Ligament (LCL) rather than its own structure.

So new or not, here’s the exciting part for skiers: 10-20% of patients with ACL reconstructions do not recover fully. The hypothesis of the two Belgians, Dr. Claes and Professor Johan Bellemans, is that many people injure the ALL at the same time as the ACL, but that only the ACL is being properly repaired. Studying the ALL may give surgeons a better understanding of the damage that happens to the knee in ACL injuries, and potentially increase the recovery rate of patients.

But before you hammer those bump runs even harder, or ride that backseat even lower like in the photo above, thinking that ACL surgery just got better, the integration of this knowledge into clinical practice is a long ways off. While some surgeons are excited about the implications of the discovery, others made the point that it is entirely unknown if operating on the ALL would actually help ACL patients.

I know a few of you readers of the Heli-Ski Blog are orthopedic knee masters who also understand skiing – what do you knee gurus think?

Photo of ACL testing by Topher Donahue.

Comments

Um, I've had each knee reconstructed, I can't really see how this ALL ligament could help repair? I mean it's still a reconstruction of a major ligament. What level of relief would using another ligament use? Or did I miss something?  
Posted @ Tuesday, November 12, 2013 8:12 AM by Hayley Ruth Melidonis
I think what these doctors are suggesting is that in some cases of ACL injury, the ALL may be damaged but is not being reconstructed, leaving the knee less stable even after the ACL reconstruction.
Posted @ Tuesday, November 12, 2013 8:45 AM by Topher Donahue
The knee is a "simple, yet complicated" joint. I'm a member of the ACL Club, and know a fair bit about knee mechanics. It would seem that all the components that hold the knee together (not just the big four ligaments) need to be working and balanced for it to be stable. If we've been missing the ALL, then that could be a source of problems...
Posted @ Tuesday, November 12, 2013 10:10 AM by Brad Nichols
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