Oh, My Achin' LigamentDoctors and surgeons now have many ways to treat ligament injuries, with or without surgery. But there are still many questions about the way ligaments heal. To summarize what is known about ligament healing, the authors focused on two different knee ligaments, the medial collateral ligament (MCL) and anterior cruciate ligament (ACL).
Athletes commonly injure both these knee ligaments. Treatments for these ligaments can range from simple remedies like rest and ice to surgery. However, no matter what kind of treatment is used, injured ligaments may never become as good as new. Two years after an injury, electron microscope studies show that the cells in the injured area are smaller in size and shape. This verifies that the ligament still hasn't returned to normal.
Ligament healing is affected by many factors. Most MCL injuries, for example, tend to heal better without surgery. Not so with ACL injuries. Doctors are not exactly sure why this is true. It may have to do with factors like blood flow to the ligament and the ligament's structure. New scientific discoveries are guiding the ways doctors and other health professionals treat injured ligaments.
The authors listed several new advances that may someday be used to speed the healing process.
- Growth factors are small polypeptides that bind to cells and promote cell growth.
- Gene transfer technology involves transplanting genetically altered tissues into the ligaments to improve healing.
- Cell therapy uses genetically altered cells to enhance ligament repair.
The authors are optimistic that new insights on ligament healing in the knee will prove useful in other parts of the body as well.
Savio L.-Y. Woo, PhD, DSc, et al. Healing and Repair of Ligament Injuries in the Knee. In Journal of the American Academy of Orthopaedic Surgeons. November/December 2000. Vol. 8. No. 6. Pp. 364-372.
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