Musculoskeletal Growth/Injury and Repair - ligament injuries

Question 1

what are ligaments?

Answer 1

• Dense bands of collagenous tissue (condensations capsule)
• Span a joint
• Anchored to the bone at either end
• Joint stability through range motion
• Different portions ligament tensioned at different joint positions
• Multiple

Question 2

what is the structure of a ligament?

Answer 2

• Collagen fibres (type 1)
• Fibroblasts (communicate)
• Sensory fibres - Proprioception, Stretch, Sensory
• Vessels (surface)
• Crimping (allow stretch)

Question 3

what is the difference between ligaments and tendons?

Answer 3

Question 4

how may ligament rupture occur and what may it cause?

Answer 4

•Forces exceed strength ligament

• Expected
• Unexpected (position/muscle)
• Rate load
• Complete vs incomplete
• Stability joint?
• Proprioception loss?

Question 5

what is the healing process of a ligament?

Answer 5

Haemorrhage:

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

Proliferative phase:

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

Remodelling:

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

Question 6

what is the treatment of ligament injuries?

Answer 6

Conservative:

• Partial
• No instability
• Poor candidate surgery

Operative:

• Instability
• Expectation (sportsmen)
• Compulsory (multiple)