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November 07, 2013

The Science Is Settled: Physicians Discover a Hitherto Unknown Part of the Body

See Update: IO9 says most of Science Daily's story is completely wrong.

Among the Settled Sciences, I would have thought Human Anatomy was among the most settled.

We've been cutting into living bodies and carving up dead ones for a long time now, haven't we?

How did we miss a a ligament? And not just a ligament in an unexpected place, like some kind of floating ligament in the stomach or something. But a ligament on a place where a lot of surgeons perform surgery to repair ligaments-- the knee.

They just never noticed it before. In 40,000 knee operations (Caveat: I'm just making this number up), no one ever noticed, "Say, there's an extra ligament in here that isn't in my book."

Now you say, "Oh, well this ligament must be very, very small."

Not so much. Not so much.

That's like the size of a finger. This is like scientists discovering "Hey, you know what? We've actually got eleven fingers. Sorry about the miscount earlier. Please buy new gloves."

Thanks to Flatbush Joe.

Update: Thanks to @theh2 and Dave in Garfield Ridge, IO9 says this story is crap. Dave adds that it's just another example of the absolute crap level of "science reporting" we've gotten used to.

IO9 says the ligament was discovered in 1879... but Science Daily mentioned that as well, or at least they characterized the 1879 mention as "postulating" the ligament. IO9 says the ligament was known, but its function was not, and the new paper is about the function of the ligament, not its mere existence.

I don't know. I kind of don't trust any science reporting. But the claim that a ligament had been newly discovered did strike me as... unbelievable, though I did believe it.

More: The abstract of the new paper begins:

In 1879, the French surgeon Segond described the existence of a ‘pearly, resistant, fibrous band’ at the anterolateral aspect of the human knee, attached to the eponymous Segond fracture. To date, the enigma surrounding this anatomical structure is reflected in confusing names such as ‘(mid-third) lateral capsular ligament’, ‘capsulo-osseous layer of the iliotibial band’ or ‘anterolateral ligament’, and no clear anatomical description has yet been provided. In this study, the presence and characteristics of Segond's ‘pearly band’, hereafter termed anterolateral ligament (ALL), was investigated in 41 unpaired, human cadaveric knees.

My ruling: It seems that the initial headlines somewhat oversold this discovery-- but only somewhat. And that IO9 is now overselling the debunking.

The ligament has been alluded to not just in the original French paper but in subsequent ones, as evidenced by the multiplicity of names for it. But it also seems that the ligament is all but unknown -- also evidenced by the fact that scientists haven't yet decided on what to call the thing.

Note the abstract states the very presence of the ALL is being investigated. If this were a well-known piece of anatomy, they would not be scrutinizing knees for the ligament's mere presence.

I tried to read the original French paper but it's well, well beyond my vocabulary.

I don't know the exact level of knowledge of this ligament, obviously, but it does seem to me the original claims somewhat overstated the "discovery," but again, only somewhat-- in history, we do recognize cases of the same lake being "discovered" multiple times. At some point it becomes important to ask, "Well, what exactly do we mean by discovered?" As with a lake, does merely seeing the lake count? Sure. But someone who does a survey later might also be credited with "discovering" it.

The IO9 article seems to speak with false authority in suggesting (while not explicitly claiming) that the ALL was well-known to medicine. Apparently it was not well-known at all.

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posted by Ace at 10:54 AM

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