What type of tissue are ligaments made from?
They are made from dense bands of collagenous tissue
Interspersed between the collagen fibers of dense connective tissue are fibroblasts which produce a collagen subunit, tropocollagen, used to construct larger collagenous aggregates
What is the purpose of ligaments?
Provide joint stability through range of motion
What sensory fibres are present in ligaments?
- Proprioception
- Stretch
- Sensory
How are ligaments different to tendons in structure?
Ligaments have
- a lower percentage of collagen
- Higher percentage of proteoglycans and water
- Less organised collagen fibres
- Rounder fibroblasts
When do ligaments rupture?
When forces exceed strength of ligament
What is the result of a complete/incomplete tendon rupture?
Incomplete rupture – the joint is still stable
If there is complete rupture then there is a chance that the joint is now unstable
What are the stages of ligament healing?
Haemorrhage
Proliferative phase
Remodelling
What happens during the haemorrhage?
- Blood clot
- resorbed
- Replaced with a heavy cellular infiltrate.
- hypertrophic vascular response
What happens during the proliferative stage of healing?
- production of “scar tissue“
- disorganised collagenous connective tissue
What happens during the remodelling stage of ligament healing?
- Matrix becomes more ligament like
- Major differences in composition, architecture and function persist.
What is the treatment for ligament injury?
- Conservative:
- Partial
- No instability
- Poor candidate surgery
- Operative:
- Instability
- Expectation (sportsmen)
- Compulsory (multiple)
Surgery is mandatory if there is multiple ligement injury
