Growth Injury and Repair - Ligament Injuries

Question 1

What type of tissue are ligaments made from?

Answer 1

They are made from dense bands of collagenous tissue

Interspersed between the collagen fibers of dense connective tissue are fibroblasts which produce a collagen subunit, tropocollagen, used to construct larger collagenous aggregates

Question 2

What is the purpose of ligaments?

Answer 2

Provide joint stability through range of motion

Question 3

What sensory fibres are present in ligaments?

Answer 3

• Proprioception
• Stretch
• Sensory

Question 4

How are ligaments different to tendons in structure?

Answer 4

Ligaments have

• a lower percentage of collagen
• Higher percentage of proteoglycans and water
• Less organised collagen fibres
• Rounder fibroblasts

Question 5

When do ligaments rupture?

Answer 5

When forces exceed strength of ligament

Question 6

What is the result of a complete/incomplete tendon rupture?

Answer 6

Incomplete rupture – the joint is still stable

If there is complete rupture then there is a chance that the joint is now unstable

Question 7

What are the stages of ligament healing?

Answer 7

Haemorrhage

Proliferative phase

Remodelling

Question 8

What happens during the haemorrhage?

Answer 8

• Blood clot
• resorbed
• Replaced with a heavy cellular infiltrate.
• hypertrophic vascular response

Question 9

What happens during the proliferative stage of healing?

Answer 9

• production of “scar tissue“
• disorganised collagenous connective tissue

Question 10

What happens during the remodelling stage of ligament healing?

Answer 10

• Matrix becomes more ligament like
• Major differences in composition, architecture and function persist.

Question 11

What is the treatment for ligament injury?

Answer 11

• Conservative:
• Partial
• No instability
• Poor candidate surgery
• Operative:
• Instability
• Expectation (sportsmen)
• Compulsory (multiple)

Surgery is mandatory if there is multiple ligement injury