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Ligament Healing: Current Knowledge and Clinical Applications

Division of Orthopaedics, University of Calgary Faculty of Medicine, Alberta.

The treatment of ligament injuries, particularly knee-ligament injuries, has occupied a substantial portion of the orthopaedic literature for several decades. It remains unclear, however, what orthopaedic surgeons can do to optimize the recovery of patients with ligament problems. In this review, the reasons for this lack of clarity are proposed, and the current state of laboratory knowledge about the response of isolated and multiple ligament injuries to various treatment modalities is reviewed for the ligaments that have been studied thus far (all of which are in the knee). In general, it appears that ligaments heal with scar tissue similar to that involved in skin-wound healing. The early controlled motion of stable (or surgically stabilized) joints appears to improve ligament scar behavior, but no treatment identified to date stimulates true ligament regeneration.