Ligament Injuries Flashcards
What are ligaments?
- Dense bands of collagenous tissue (condensations capsule) which span a joint
- They are anchored to the bone at either end
What is the function of ligaments?
Offer joint stability through a range of motion (different portions ligament tensioned at different positions)
What is the structure of ligaments?
- Composed of collagen fibres (type 1) and fibroblasts (communicate)
- Have sensory fibres for proprioception, stretch and sensory
- Vessels at the surface
- Crimping allows stretch
How do ligaments compare to tendons in composition?
Compare to tendons, ligaments have:
- Lower percentage of collagen
- Higher percentage of proteoglycans and water
- Less organised collagen fibres
- Rounder fibroblasts
When does ligament rupture occur?
- Forces exceed strength of ligament (expected/unexpected/rate loaded)
- Can be complete or incomplete
What can ligament rupture result in?
- Loss of stability in the joint
- Proprioception loss
What are the 3 stages of ligament healing?
- Haemorrhage
- Proliferative stage
- Remodelling
What is involved in the haemorrhage stage of healing?
- Blood clot which is resorbed
- Replaced with a heavy cellular infiltrate
- Hypertrophic vascular response
What is involved in the proliferative stage of healing?
- Production of scar tissue
- Disorganised collagenous connective tissue
What is involved in the remodelling stage of healing?
- Matrix becomes more ligament like
- Major differences in composition, architecture and function persist
When is conservative treatment opted for in ligament ruptures?
- Partial tears
- No instability of joint
- Poor candidate for surgery
When is surgery opted for, in ligament ruptures?
- Instability
- Expectation (sports)
- Compulsory (multiple)
