Research by Belgian surgeons into a previously unfamiliar ligament in the knee joint suggests the newly-named anterolateral ligament (ALL) could play a small but important role in boosting the success rate of knee reconstructions.
Specifically, an injury to the ALL could explain why a small percentage of patients who have undergone an anterior cruciate ligament (ACL) reconstruction complain of their repaired knee giving way when they twist or turn.
The Belgian team also believes some people could sustain damage to their ALL at the same time as injuring their ACL, making the knee less stable.
But despite the initial burst of excitement surrounding the research, Feller told AFL.com.au it was unlikely to change the way ACL injuries are treated.
"It's not a new ligament," Feller said.
"The ligament's always been there. It's been described by others back as far as the 1800s."
"The authors have gone on, and maybe gone a little bit too far, I suspect, but what they're suggesting is that there's a group of people (who) after a anterior cruciate ligament reconstruction seem to have ongoing instability.
"It's not a big group, but it definitely exists and people have had different explanations of that over the last 10 years, and now they're looking at whether it might be in fact an unrecognised injury to this ligament that might be the cause of ongoing instability in those people."
"It probably won't have as much impact as you might initially expect. I guess it means one looks more closely at an MRI for an injury in that area, but that's always been recognised. It's not new, even when you just examine someone's knee who's torn an anterior cruciate ligament. They're often tender at that spot so it's well recognised there's an injury there."
While the ALL may play a role in recurrent ACL injuries, Feller said repairing the ligament could be detrimental for an AFL player.
"Maybe there might be occasional circumstances where you might consider it," he said.
"[For example], players who have had an ACL reconstruction and maybe their knee still feels a little bit wobbly, or they've had reconstruction and got back but it ruptures for no obvious reason, so when you go back and re-do it you might look at ways of beefing up the reconstruction, if you like, and do something in the region of that anterolateral ligament.
"[But] I'm not sure that would be a great idea to adopt that as a routine, because you might end up with knees that are a bit stiff."
