Scar formation and ligament healing

Ligaments are highly organized, dense, fibrous connective-tissue structures that provide stability to joints and participate in joint proprioception. Injuries to ligaments induce a healing response that is characterized by th e formation of a scar. The scar tissue is weaker, larger and creeps more th an normal ligament and is associated with an increased amount of minor coll agens (types III, V and VI), decreased collagen crosslinks and an increased amount of glycosaminoglycans. Studies have shown that certain surgical Var iables alter the healing of ligaments. Such factors include the size of gap between the healing ligament ends,the use of motion in a stable joint and the presence of multiple ligamentous injuries. Research on ligament healing includes studies on low-load and failure-load properties, alterations in t he expression of matrix molecules, cytokine modulation of healing and gene therapy as a method to alter matrix protein and cytokine production.