Download Lecture 5 healing of various tissues 2016

Healing of various
Tissues
Review of tissue Injuries
Ligament Sprains
 A ligament is a tough
,relatively inelastic
band of tissue that
connects bone to
bone
 Function three fold
 To provide stability
 To provide control
of position
 To provide
proprioceptive
input sense of its
position
Ligament Sprains
 Ligament is torn - ends are frayed , approximation of
these ends will help to determine healing
 Sprained Extra-articular ligaments bleeding will occur
in a subcutaneous space
 Sprained intra-articular ligaments bleeding will occur
inside the joint capsule
 Remodeling 6 weeks – 12 months , normal strength
can take up to a year to be restored
Factors Affecting Ligament
Healing
 Actively exercised ligaments are stronger than
immobilized ligaments
 Therefore it is important to minimize immobilization
periods
 It is not likely that the inherent stability of the joint will
be regained
 Therefore other surrounding structures must be
strengthened
Fractures to Bone
 Extremely common
in sports, classified
as either OPEN or
CLOSED
 Varieties of
fractures
 Greenstick
 Transverse
 Oblique
 Spiral
 Comminuted
 Impacted
 Avulsed
 Stress
Bone Healing
 Time required for healing is variable
 3-4 months fracture healed but remodeling still
occurring
 12 weeks normal strength attained
 Healing does depends on location , severity of
fracture, age of patient
Cartilage Damage
 Arthrosis is primarily
a degeneration
process with
destruction of the
cartilage
 Chondromalacia- is
the non-progressive
transformation of
cartilage with
irregular surfaces
and areas of
softening
Cartilage Healing
 Cartilage has a relatively limited healing capacity
 Depends on three variables
 -depth of defect
 -maturity of cartilage
 -Location of defect
 Poor vascular supply
 Reparative procedures – clean the joint – repair the
joint – restore the joint
 Replace the joint
Muscle strains
 Muscle is
Elastic
Extensible
Excitable
Contractible
 Damage may
occur in the
muscle, at the
musculotendinous
junction or in the
tendon
 Three grades
Muscle healing
 Muscle does have unique ability to
regenerate if damage small enough
 Larger muscle injuries unable to regenerate
must resort to scar tissue
 Remodeling 6-weeks to 6 months for 90 %
healing
 Incapacitating muscle strains often occur in
large force producing muscles ( quads ,
hamstrings)
 Hamstrings may require at least 6- 8 weeks
and considerable amount of patience
 Attempts to return to soon frequently cause
re-injury to the area and then the healing
process must start again
Tendinitis
 Most common
overuse problem is
tendinitis
 Tendinitis is a catch
all term used to
describe many
different
pathological
conditions of a
tendon
 It essentially
describes any
inflammatory
response with in the
tendon
Tendon healing
 Formation of a scar , important that it does not
become thick , and dense, this may limit the gliding of
the tendon
 The resulting scar tissue must be able to allow normal
ROM and muscle activity
 Remodeling 40 – 50 weeks for 85-95 % healing