Ligament Injury

Question 1

What is a ligament?

Answer 1

• Dense bands of collagenous tissue
• Span a joint
• Anchored to each bone at either end

Question 2

What is the role of ligaments?

Answer 2

• Provide joint stability through a range of motion
• Different sections will be tensioned at different joint positions

Question 3

What are the 5 components of ligament structure?

Answer 3

1. Collagen fibres (type 1)
2. Fibroblasts
3. Sensory fibres [proprioception, stretch, sensory]
4. Vessels
5. Crimping [to allow stretch]

Question 4

What is the difference between ligament structure and tendon structure?

Answer 4

• They have more crimping to allow for more stretch

Question 5

Why do ligaments rupture?

Answer 5

• Due to forces exceeding their strength limit
  
  • The rate and whether it was expected or unexpected force will effect damage

Question 6

What are the effects of ligament rupture?

Answer 6

• Loss of joint stability
• Potential loss of proprioception

Question 7

What are the three stages of ligament repair?

Answer 7

• Haemorrage
• Proliferative
• Remodelling

Question 8

Explain the haemorrhage phase [phase 1] of ligament repair.

Answer 8

• Blood clot forms
• Resorbed
• Replaced with heavy cellular infiltrate
• Hypertrophic vascular response

Question 9

Explain the proliferative phase [phase 2] of ligament repair.

Answer 9

• Production of scar tissue
• Disorganised collagenous connective tissue

Question 10

Explain the remodelling phase [phase 3] of ligament repair.

Answer 10

• Matrix becomes more ligament like
• However, major differences between architecture, composition and function persist

Question 11

What are the main treatment options for ligament damage?

Answer 11

• Conservative if:
  
  • No instability
  • Partial damage
  • Poor candidate for surgery
• Operative if:
  
  • Instability
  • Expectation (sportsman)
  • Compulsary (multiple)