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.
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.