New Knee Ligament Found (Again)

[jiveturkey]

There's some cool photos in the link.

http://www.ideastream.org/news/npr/243710560

Doctors have long overlooked a tiny band that connects two bones in the knee. Now Belgium surgeons say that's a mistake. The obscure structure is a full-fledged ligament. When it malfunctions, people recovering from anterior cruciate ligament injuries may run into trouble.

About 150 years ago, a prestigious surgeon in Paris found a new body part while operating on some his patients. He described the structure as a pearly, "fibrous band" on the outside of the bones in the knee.

That sure sounds like a ligament. But nobody really gave it much thought. And poof! Over the next hundred years or so, the body part was pretty much forgotten.

Then in the 1970s, the mysterious band of tissue reappeared in the medical literature every now and then. It went by several names. No one was really sure what the heck it was doing or even could tell with certainty which bones it connected.

Until now.

Orthopedic surgeons in Belgium have hunted down the enigmatic structure in cadavers. And what do you know — the good Parisian doctor was right.

There is an overlooked ligament in the knee. And it might be important for keeping your knee from twisting and turning, especially after an injury to the anterior cruciate ligament, or ACL.

Dr. Johan Bellemans and his team at the University Hospital Leuven described the ligament a few months ago in the Journal of Anatomy. They named it the anterolateral ligament, or ALL, and they offered the first clear data on what it's function is.

"It's eye-opening and provocative work," says Scott Rodeo, the chief of orthopedic surgery at the Hospital For Special Surgery in New York City. He wasn't involved in the study, but he saw Bellemans' team present the work at a conference.

"We've known for years that there was a hardened, fibrous tissue in this location," he tells Shots. "And that this area of tissue plays some role. So it's not such a dramatic discovery but kind of a rediscovery — or a refocusing of attention."

The ALL is about the length of a small thumb. The band connects the thigh bone to the shinbone on the outside of the leg. The ligament probably helps to keep the knee from rotating inward, the researchers suggest.

Damage to the ALL may be one reason why some people don't bounce back after ACL surgery. About 9 in 10 people who have their ACL repaired can return to sports with no problems at all, Rodeo says. But for some, the knee still isn't quite right. It buckles abnormally or gives way during sports.

"The ALL may have a role in small percentage of patients with persistent problems after the reconstruction of their ACL," Rodeo says. "We need to learn more about its function and pay more attention to it."

Even after ACL surgery is successful, Rodeo says, about half of people develop arthritis in the knee 15 years later.

"The next frontier in knee surgery is preventing arthritis," he says. "Should we start to focus on this ligamet? Maybe."

[AustinChief]

Originally Posted by Ebolapox

eh, AIDS falls under the realm of molecular from a technical perspective

And all of biology falls under physics and all of science falls under quantum physics... which if you are a disciple of Wheeler falls under Information (mathematics) etc etc

But not exactly my point

['Hamas' Jenkins]

Originally Posted by AustinChief

Not entirely serious (quite a bit of hyperbole) but I have long struggled with the slipshod science that goes on in the medical field. This is a near PERFECT example. Exactly HOW does something like this get "missed?"

This isn;t really a terribly unique situation. This kind of arrogant assumption of "we know everything" about a particular subject (anatomy) happens ALL THE TIME in medicine. My favorite is in virology when something can't be explained and so they just make shit up. Can't explain why the AIDS virus doesn;t show up for years? Oh well, umm... it's DORMANT! yeah that's it. Of course that supposition was completely wrong and yet it was held as fact without a shred of evidence. I can go on and on with examples of shoddy lazy science in the field. (yes it happens in other fields as well but none that I have seen to the degree it does here)

That may have been an incorrect assumption (of course, molecular, as Ebola points out), but it wasn't without precedent. There are a litany of viruses and other microorganisms that lay dormant for months-years at a time--CMV and various herpes viruses for example.

[AustinChief]

Originally Posted by 'Hamas' Jenkins

That may have been an incorrect assumption (of course, molecular, as Ebola points out), but it wasn't without precedent. There are a litany of viruses and other microorganisms that lay dormant for months-years at a time--CMV and various herpes viruses for example.

Actually that's not entirely true (I can address this if you want but TRUE dormancy isn't nearly as common as people think) BUT it doesn't matter if there is a precedent. I expect more than just a good guess when it comes to SCIENCE. Especially when some jagoffs guess was accepted as fact for what? Over a decade?

Anyway, my bitch is that there is far far far too much shoddy "science" in the medical field and the entire field is far too forgiving of it. I'm not some anti-science weirdo who believes in crystals or chiropractors or other voodoo bullshit. Quite the opposite, I just want better, HARDER science with my medicine.

P.S. as I stated that is not MOLECULAR BIOLOGY unless you want to state (which is true) that everything can be REDUCED to molecular biology.

[cdcox]

Originally Posted by AustinChief

Not entirely serious (quite a bit of hyperbole) but I have long struggled with the slipshod science that goes on in the medical field. This is a near PERFECT example. Exactly HOW does something like this get "missed?"

This isn't really a terribly unique situation. This kind of arrogant assumption of "we know everything" about a particular subject (anatomy) happens ALL THE TIME in medicine. My favorite is in virology when something can't be explained and so they just make shit up. Can't explain why the AIDS virus doesn't show up for years? Oh well, umm... it's DORMANT! yeah that's it. Of course that supposition was completely wrong and yet it was held as fact without a shred of evidence. I can go on and on with examples of shoddy lazy science in the field. (yes it happens in other fields as well but none that I have seen to the degree it does here)

Uh, there was a paper published in Nature last week that said not all dormant HIV can reactivate. Is that what you are talking about or is it something else? Not sure what you are talking about when you say it doesn't go dormant (actually latent is a better term).

['Hamas' Jenkins]

Originally Posted by AustinChief

Actually that's not entirely true (I can address this if you want but TRUE dormancy isn't nearly as common as people think) BUT it doesn't matter if there is a precedent. I expect more than just a good guess when it comes to SCIENCE. Especially when some jagoffs guess was accepted as fact for what? Over a decade?

Anyway, my bitch is that there is far far far too much shoddy "science" in the medical field and the entire field is far too forgiving of it. I'm not some anti-science weirdo who believes in crystals or chiropractors or other voodoo bullshit. Quite the opposite, I just want better, HARDER science with my medicine.

P.S. as I stated that is not MOLECULAR BIOLOGY unless you want to state (which is true) that everything can be REDUCED to molecular biology.

Whether you want to reduce it to dormancy or latency it's ultimately semantic.

It wasn't stated as a law, but that was the best assumption given that you had a period of clinical latency for nearly a decade despite evidence of a virus that destroys CD4 cells and other elements of the immune system.

Ultimately, you are expecting better "harder" science there, while conveniently ignoring the litanies of false proclamations made by those you most prize.

Surely you remember the claim that the human genome would find over 2 million unique genes.

['Hamas' Jenkins]

Originally Posted by cdcox

Uh, there was a paper published in Nature last week that said not all dormant HIV can reactivate. Is that what you are talking about or is it something else? Not sure what you are talking about when you say it doesn't go dormant (actually latent is a better term).

In the mid 80s there was a belief that patients took a long time to display clinical signs of AIDS because HIV entered a latent period after primary infection. David Ho (the same guy who pioneered HAART and won Time's Man of the Year) ultimately found that the immune system puts up a hell of a fight for years upon years, and it is only after nearly a decade (in most individuals) that the constant assault begins to exhaust its defenses.

That was part of the reason behind the initial theraputic push called "hit it hard, hit it early."

[AustinChief]

Originally Posted by cdcox

Uh, there was a paper published in Nature last week that said not all dormant HIV can reactivate. Is that what you are talking about or is it something else? Not sure what you are talking about when you say it doesn't go dormant (actually latent is a better term).

And yes latent is a better term and no that isn't what I was referring to. I was referring to the early (way back) assumption that HIV, once contracted, laid dormant for years before attacking the body and becoming AIDS. This of course was shown to be complete hogwash. Yet it was a working assumption for years.

And yes I read the article you mentioned and another that was bit more hopeful on the subject. I'll see if I can find it.

[AustinChief]

Originally Posted by 'Hamas' Jenkins

Whether you want to reduce it to dormancy or latency it's ultimately semantic.

true

Originally Posted by 'Hamas' Jenkins

It wasn't stated as a law, but that was the best assumption given that you had a period of clinical latency for nearly a decade despite evidence of a virus that destroys CD4 cells and other elements of the immune system.

Baseless assumptions like this should be treated as such. It was not.

Originally Posted by 'Hamas' Jenkins

Ultimately, you are expecting better "harder" science there, while conveniently ignoring the litanies of false proclamations made by those you most prize.

Surely you remember the claim that the human genome would find over 2 million unique genes.

Oh, I am not saying that the geneticists are perfect by any means. No field is perfect. I am just talking relative standards of acceptability. Pointing out to me the failings of one doesn't less the far greater failings of the other.

[AustinChief]

Originally Posted by 'Hamas' Jenkins

In the mid 80s there was a belief that patients took a long time to display clinical signs of AIDS because HIV entered a latent period after primary infection. David Ho (the same guy who pioneered HAART and won Time's Man of the Year) ultimately found that the immune system puts up a hell of a fight for years upon years, and it is only after nearly a decade (in most individuals) that the constant assault begins to exhaust its defenses.

That was part of the reason behind the initial theraputic push called "hit it hard, hit it early."

Ok, your explanation was far better...

CDcox, ignore my post and pretend I said this.

[cdcox]

Originally Posted by 'Hamas' Jenkins

In the mid 80s there was a belief that patients took a long time to display clinical signs of AIDS because HIV entered a latent period after primary infection. David Ho (the same guy who pioneered HAART and won Time's Man of the Year) ultimately found that the immune system puts up a hell of a fight for years upon years, and it is only after nearly a decade (in most individuals) that the constant assault begins to exhaust its defenses.

That was part of the reason behind the initial theraputic push called "hit it hard, hit it early."

Ok. I know that HIV can incorporate its DNA into the human genome and go latent (no active virus particles) for many years. Anti-viral drugs aren't effective because there are no viruses. That DNA can come out of latency and reactivate into new active virus particles under certain conditions. The latency coupled with a propensity to mutate are the key reasons why HIV is so difficult to eradicate from the human body. I thought Austin was claiming that this model of the HIV virus had recently been disproven. I would have heard about that.

I'm not familiar all the dismissed theories of HIV from the 1980s.

['Hamas' Jenkins]

Originally Posted by AustinChief

Oh, I am not saying that the geneticists are perfect by any means. No field is perfect. I am just talking relative standards of acceptability. Pointing out to me the failings of one doesn't less the far greater failings of the other.

Personally, I am not aware of evidence that medical doctors make errors at significantly higher rates than do researchers.

[cdcox]

Practitioners and researchers are two different animals. It's like comparing a coal fired power plant operator to someone researching fusion reactors as a power source.

[AustinChief]

Originally Posted by 'Hamas' Jenkins

Personally, I am not aware of evidence that medical doctors make errors at significantly higher rates than do researchers.

Originally Posted by cdcox

Practitioners and researchers are two different animals. It's like comparing a coal fired power plant operator to someone researching fusion reactors as a power source.

Agreed, I wasn't talking about your average practicing doctors. That is an entirely different rant.

And to be honest my bias is just that... MY BIAS based on my perception of different aspects of the field over the years. As someone who respects science I will fully admit that I am limited in that regard and could be wrong. But SERIOUSLY, a LIGAMENT? That's ****ed up.

[cdcox]

Originally Posted by AustinChief

Agreed, I wasn't talking about your average practicing doctors. That is an entirely different rant.

And to be honest my bias is just that... MY BIAS based on my perception of different aspects of the field over the years. As someone who respects science I will fully admit that I am limited in that regard and could be wrong. But SERIOUSLY, a LIGAMENT? That's ****ed up.

The media is horrendously bad at getting the facts correct when it comes to science. I haven't researched this one, but I wouldn't be at all surprised if the popular press account contained huge exaggerations of the state of ignorance concerning that particular ligament among knee specialists. Just a guess.

[Carlota69]

I am currently recovering from ACL reconstruction and I'm doing ok, but even after 9 months, its difficult to run, in fact, I don't because my knee swells bad and it ****ing hurts. Plus lounges have been difficult. I wonder if my ALL is all ****ed up. I do have pain on the outside of my knee.