Thursday, November 7, 2013

The Unknown Unknowns

As I was saying...

New Ligament Discovered‬ In the Human Knee
Despite a successful ACL repair surgery and rehabilitation, some patients with ACL-repaired knees continue to experience so-called 'pivot shift', or episodes where the knee 'gives way' during activity. For the last four years, orthopedic surgeons Dr Steven Claes and Professor Dr Johan Bellemans have been conducting research into serious ACL injuries in an effort to find out why. Their starting point: an 1879 article by a French surgeon that postulated the existence of an additional ligament located on the anterior of the human knee.
That postulation turned out to be correct: the Belgian doctors are the first to identify the previously unknown ligament after a broad cadaver study using macroscopic dissection techniques. Their research shows that the ligament, which was given the name anterolateral ligament (ALL), is present in 97 per cent of all human knees. Subsequent research shows that pivot shift, the giving way of the knee in patients with an ACL tear, is caused by an injury in the ALL ligament.
This is a perfect example of doctors confidently acting despite the absence of information.
This is basic anatomy, people.   Should have been found a hundred years ago.
Nonetheless, surgeons have performed millions of these knee surgeries assuming they knew what they were doing.