Tissue Healing Flashcards
Acute timeline
7-10 days
Subacute timeline
5-10 days after acute
Chronic timeline
Injury lasting longer than expected under “normal” healing conditions
Ligament Phase I
- Acute inflammatory response and hematoma formation
- Days 1-3
Ligament Phase II
- Fibroblasts produce collagen
- Matrix disorganized
- 2-3 days post injury to 6 weeks
Ligament Phase III
- Collagen fibers become more parallel/organized
- Increased tissue contraction and tensile strength
- 12 months post injury
Tendon Phase I
Inflammatory
1st 3 days
Tendon Phase II
- Begins within 1st week
- Increased fibroblastic activity through week 4
- Collagen fibers initially formed disorganized and at random
- Cells and collagen become more aligned more perpendicular to long axis over time
Tendon Phase III
- Collagen / cells re-alignment typically complete by 2 months
- After initial healing CONTROLLED tensile loading
Articular cartilage:
Chondral
Limited response per no inflammatory response
Articular cartilage: Subchondral
- Extends to blood supply
- Fills in with tissue more like fibrocartilage
- Fibrin clot at 48 hrs
- 2 months resembles “normal” cartilage
- erosive changes observed around 6 months
Articular cartilage: Subchondral
When does cartilage resemble “normal” cartilage?
2 months
Articular cartilage: Subchondral
When are erosive changes observed?
6 months
Articular cartilage: Subchondral
When do you see a fibrin clot?
48 hrs
Articular cartilage: Subchondral
What type of cartilage fills in initially?
fibrocartilage
Articular cartilage: Subchondral
mechanical injury types
blunt trauma
penetrating injury
sharp concentration of joint forces
Bone Healing:
Immobilization time for adults
6-8 weeks
Bone Healing:
Immobilization time for children
4-6 weeks
Bone Healing:
Early excessive loading risk
pseudoarthrosis
Arthrogenic Muscle Inhibition
continued reflex inhibition of musculature surrounding a joint folloing injury or joint effusion
Neuromuscular (functional) instability
Poor NM control resulting in aberrant movement patters and subsequent harm to involved structures
Structural instability
Disruption in the continuity of an anatomic structure, limiting structure’s ability to accept loading
