Ligament Injuries and Repairs Flashcards
What are the four phases of ligament repair?
Hemorrhagic phase
Inflammatory Phase
Fibroblastic Phase
Remodeling phase
What occurs during the hemorrhagic phase?
bleeding around the injury site results in the formation of a haematoma
What occurs during the inflammatory phase?
infiltration of the haematoma by inflammatory cells - e.g. macrophages
- haematoma is replaced by granulation tissue
What occurs during the fibroblastic phase?
fibroblasts secrete ECM and immature type 3 collagen
What occurs during the remodelling phase?
organization of tissues, reduction in cellular components and increase in fibrous components
Type 1 collagen replaces type 3 - remodeled along the lines of stress
What is the makeup of a ligament following tears?
similar to pre-injury state but continuous remodeling results in scar formation and the new ligament is less extensible than before
What is a first-degree ligament tear?
less than 1/3rd of the ligament substance is damaged
What are the signs of a first-degree ligament tear?
localized swelling and tenderness - pain on stress testing with no instability
Why is there no instability with a first-degree ligament tear?
intact fibres splint the damaged area
What is a second-degree ligament tear?
1/3rd to 2/3rds of the ligament substance is damaged
What are the signs of a second-degree ligament tear?
localized swelling and effusion
more extensive tenderness
a subjective complaint of instability
Why is there an effusion with a second-degree ligament tear?
damage to the synovial membrane as part of the MOI
What is a third-degree ligament tear?
over 2/3rds of ligament substance damaged - may be a complete rupture
What are the signs of a third-degree ligament tear?
severe pain, effusion, instability, marked decrease in ROM
Why is there a decrease in ROM in a third-degree ligament tear?
Marked pain and swelling - may have also damaged other structures in and around the joint
