Tendon and Ligament Disease Flashcards
What could you potentially find on palpation?
- Heat
- Sensitivity to digital pressure
- Swelling or thickening
- Specific loss of definition on the margins
- Reduced ROM (range of motion)
What are the types of Tendon lesion?
- Core lesion
- Margin tears or flaps
- Fibrillation
- Avulsions/ Rupture
- Adhesions/ Contracture
What are the types of ligament lesion?
- Strains
- Enthesopathy
- Desmopathy
- Avulsions
What are tenocytes?
Elongated fibroblasts
What are the two protective mechanisms for the tendon?
- Tendon Sheath
- Bursa
What is the function of the tendon protective mechanisms?
They are designed to protect the tendons from shear damage
* frictionless tendon gliding
* Dictates the tendon orientation
* Synovial fluid assists in movement
What is the downside of the tendon sheath?
limit healing capacity
Paratenon is absent
Synovial fluid interrupts the healing matrix
What is the function of the ligament?
Transmits forces from bone to bone
* Mainly tensile
* Good structural integrity of the joints
What does an aging tendon look like?
- Darker brown and reddish centre at post mortem
- Focal sites of chrondroid
- Osseous metaplasia
What decides how tendons and ligaments heal?
- Depends on the location of the lesion
- Depends on the duration of the lesion
- Depends on the severity of the lesion
What does microdamage cause?
- Fibril breakdown
- Loss of structural cross links between collagen fibres
- Chondroid metaplasia
- Ischaemia due to rupture of capillaries
What is tenorrhapy?
Tendon Suture, Tenosuture, Tendinosuture
What is the aim of ligament surgical repair?
- Aims to restore Joint Stability
- Suture repair as for tendons
- Anchor through the bone tunnel
- Screw and washer for avulsions
- Prosthetics or implants for restoring joints
- Immobilisation -> Arthrodesis as a salvage procedure
What does tendon rehabilitation comprise of?
- Controlled exercise programme
- Daily stretches
- Modalities -> Promote further healing and may reduce the inflammation created by exercise
How might you prevent tendon and ligament injury?
Progressive increases in demands – gradually challenge the system
¡ Sensible approach to fitness
¡ Warm up tissues – e.g. before starting to stretch
¡ Cool down tissues
¡ Regular stretching - don’t expect it to be easy to begin with!
¡ Hydration – helps to keep tissue elastic
¡ Rest days
¡ Appropriate nutrition
¡ Adequate support (where previous injury present)
