Ligament

Last updated
Ligament
Details
System Musculoskeletal system
FunctionConnect bones to other bones; maintain position of organs
Identifiers
Latin ligamentum (Plural: ligamenta)
MeSH D008022
TA98 A03.0.00.034
FMA 70773 30319, 70773
Anatomical terminology

A ligament is the fibrous connective tissue that connects bones to other bones. It also connects flight feathers to bones, in dinosaurs and birds. All 30,000 species of amniotes (land animals with internal bones) have ligaments.

Contents

It is also known as articular ligament, articular larua, [1] fibrous ligament, or true ligament.

Comparative anatomy

Ligaments are similar to tendons and fasciae as they are all made of connective tissue. [2] The differences among them are in the connections that they make: ligaments connect one bone to another bone, tendons connect muscle to bone, and fasciae connect muscles to other muscles. These are all found in the skeletal system of the human body. Ligaments cannot usually be regenerated naturally; however, there are periodontal ligament stem cells located near the periodontal ligament which are involved in the adult regeneration of periodontist ligament.

The study of ligaments is known as desmology .

Humans

Other ligaments in the body include the:


Articular ligaments

Articular ligament Ligament.jpg
Articular ligament

"Ligament" most commonly refers to a band of dense regular connective tissue bundles made of collagenous fibers, with bundles protected by dense irregular connective tissue sheaths. Ligaments connect bones to other bones to form joints, while tendons connect bone to muscle. Some ligaments limit the mobility of articulations or prevent certain movements altogether.

Capsular ligaments are part of the articular capsule that surrounds synovial joints. They act as mechanical reinforcements. Extra-capsular ligaments join in harmony with the other ligaments and provide joint stability. Intra-capsular ligaments, which are much less common,[ citation needed ] also provide stability but permit a far larger range of motion. Cruciate ligaments are paired ligaments in the form of a cross. [3]

Ligaments are viscoelastic. They gradually strain when under tension and return to their original shape when the tension is removed. However, they cannot retain their original shape when extended past a certain point or for a prolonged period of time. [4] This is one reason why dislocated joints must be set as quickly as possible: if the ligaments lengthen too much, then the joint will be weakened, becoming prone to future dislocations. Athletes, gymnasts, dancers, and martial artists perform stretching exercises to lengthen their ligaments, making their joints more supple.

The term hypermobility refers to the characteristic of people with more-elastic ligaments, allowing their joints to stretch and contort further; this is sometimes still called double-jointedness.

Hypermobile finger Hypermobility-10.jpg
Hypermobile finger

The consequence of a broken ligament can be instability of the joint. Not all broken ligaments need surgery, but, if surgery is needed to stabilise the joint, the broken ligament can be repaired. Scar tissue may prevent this. If it is not possible to fix the broken ligament, other procedures such as the Brunelli procedure can correct the instability. Instability of a joint can over time lead to wear of the cartilage and eventually to osteoarthritis.

Artificial ligaments

One of the most often torn ligaments in the body is the anterior cruciate ligament (ACL). The ACL is one of the ligaments crucial to knee stability and persons who tear their ACL often undergo reconstructive surgery, which can be done through a variety of techniques and materials. One of these techniques is the replacement of the ligament with an artificial material. Artificial ligaments are a synthetic material composed of a polymer, such as polyacrylonitrile fiber, polypropylene, PET (polyethylene terephthalate), or polyNaSS poly(sodium styrene sulfonate). [5]

Examples

There are about 900 ligaments in an average adult human body, [6] [7] of which about 25 are listed here.

Head and neck
Thorax
Pelvis
Wrist
Knee

Peritoneal ligaments

Certain folds of peritoneum are referred to as ligaments. Examples include:

Fetal remnant ligaments

Certain tubular structures from the fetal period are referred to as ligaments after they close up and turn into cord-like structures:[ citation needed ]

FetalAdult
ductus arteriosus ligamentum arteriosum
extra-hepatic portion of the fetal left umbilical vein ligamentum teres hepatis (the "round ligament of the liver").
intra-hepatic portion of the fetal left umbilical vein (the ductus venosus) ligamentum venosum
distal portions of the fetal left and right umbilical arteries medial umbilical ligaments

See also

Related Research Articles

<span class="mw-page-title-main">Knee</span> Leg joint in primates

In humans and other primates, the knee joins the thigh with the leg and consists of two joints: one between the femur and tibia, and one between the femur and patella. It is the largest joint in the human body. The knee is a modified hinge joint, which permits flexion and extension as well as slight internal and external rotation. The knee is vulnerable to injury and to the development of osteoarthritis.

<span class="mw-page-title-main">Temporomandibular joint</span> Joints connecting the jawbone to the skull

In anatomy, the temporomandibular joints (TMJ) are the two joints connecting the jawbone to the skull. It is a bilateral synovial articulation between the temporal bone of the skull above and the condylar process of mandible below; it is from these bones that its name is derived. The joints are unique in their bilateral function, being connected via the mandible.

<span class="mw-page-title-main">Tibia</span> Leg bone in vertebrates

The tibia, also known as the shinbone or shankbone, is the larger, stronger, and anterior (frontal) of the two bones in the leg below the knee in vertebrates ; it connects the knee with the ankle. The tibia is found on the medial side of the leg next to the fibula and closer to the median plane. The tibia is connected to the fibula by the interosseous membrane of leg, forming a type of fibrous joint called a syndesmosis with very little movement. The tibia is named for the flute tibia. It is the second largest bone in the human body, after the femur. The leg bones are the strongest long bones as they support the rest of the body.

<span class="mw-page-title-main">Fibula</span> Leg bone in vertebrates

The fibula or calf bone is a leg bone on the lateral side of the tibia, to which it is connected above and below. It is the smaller of the two bones and, in proportion to its length, the most slender of all the long bones. Its upper extremity is small, placed toward the back of the head of the tibia, below the knee joint and excluded from the formation of this joint. Its lower extremity inclines a little forward, so as to be on a plane anterior to that of the upper end; it projects below the tibia and forms the lateral part of the ankle joint.

<span class="mw-page-title-main">Pubic symphysis</span> Cartilaginous joint between the front of the left and right hip bones

The pubic symphysis is a secondary cartilaginous joint between the left and right superior rami of the pubis of the hip bones. It is in front of and below the urinary bladder. In males, the suspensory ligament of the penis attaches to the pubic symphysis. In females, the pubic symphysis is attached to the suspensory ligament of the clitoris. In most adults, it can be moved roughly 2 mm and with 1 degree rotation. This increases for women at the time of childbirth.

A sprain is a soft tissue injury of the ligaments within a joint, often caused by a sudden movement abruptly forcing the joint to exceed its functional range of motion. Ligaments are tough, inelastic fibers made of collagen that connect two or more bones to form a joint and are important for joint stability and proprioception, which is the body's sense of limb position and movement. Sprains may be mild, moderate, or severe, with the latter two classes involving some degree of tearing of the ligament. Sprains can occur at any joint but most commonly occur in the ankle, knee, or wrist. An equivalent injury to a muscle or tendon is known as a strain.

<span class="mw-page-title-main">Anterior cruciate ligament</span> Type of cruciate ligament in the human knee

The anterior cruciate ligament (ACL) is one of a pair of cruciate ligaments in the human knee. The two ligaments are called "cruciform" ligaments, as they are arranged in a crossed formation. In the quadruped stifle joint, based on its anatomical position, it is also referred to as the cranial cruciate ligament. The term cruciate is Latin for cross. This name is fitting because the ACL crosses the posterior cruciate ligament to form an "X". It is composed of strong, fibrous material and assists in controlling excessive motion by limiting mobility of the joint. The anterior cruciate ligament is one of the four main ligaments of the knee, providing 85% of the restraining force to anterior tibial displacement at 30 and 90° of knee flexion. The ACL is the most frequently injured ligament in the knee.

<span class="mw-page-title-main">Human musculoskeletal system</span> Organ system that gives humans the capacity to move by using their muscular and skeletal systems

The human musculoskeletal system is an organ system that gives humans the ability to move using their muscular and skeletal systems. The musculoskeletal system provides form, support, stability, and movement to the body.

A soft tissue injury is the damage of muscles, ligaments and tendons throughout the body. Common soft tissue injuries usually occur from a sprain, strain, a one-off blow resulting in a contusion or overuse of a particular part of the body. Soft tissue injuries can result in pain, swelling, bruising and loss of function.

<span class="mw-page-title-main">Anterior cruciate ligament reconstruction</span> Surgical process

Anterior cruciate ligament reconstruction is a surgical tissue graft replacement of the anterior cruciate ligament, located in the knee, to restore its function after an injury. The torn ligament can either be removed from the knee, or preserved before reconstruction through an arthroscopic procedure. ACL repair is also a surgical option. This involves repairing the ACL by re-attaching it, instead of performing a reconstruction. Theoretical advantages of repair include faster recovery and a lack of donor site morbidity, but randomised controlled trials and long-term data regarding re-rupture rates using contemporary surgical techniques are lacking.

<span class="mw-page-title-main">Dense connective tissue</span> Type of connective tissue in animals

Dense connective tissue, also called dense fibrous tissue, is a type of connective tissue with fibers as its main matrix element. The fibers are mainly composed of type I collagen. Crowded between the collagen fibers are rows of fibroblasts, fiber-forming cells, that generate the fibers. Dense connective tissue forms strong, rope-like structures such as tendons and ligaments. Tendons attach skeletal muscles to bones; ligaments connect bones to bones at joints. Ligaments are more stretchy and contain more elastic fibers than tendons. Dense connective tissue also make up the lower layers of the skin (dermis), where it is arranged in sheets. In addition, the sclera contains dense connective tissue

Deep fascia is a fascia, a layer of dense connective tissue that can surround individual muscles and groups of muscles to separate into fascial compartments.

<span class="mw-page-title-main">Zona orbicularis</span> Ligament of the hip

The zona orbicularis or annular ligament is a ligament on the neck of the femur formed by the circular fibers of the articular capsule of the hip joint. It is also known as the orbicular zone, ring ligament, and zonular band.

<span class="mw-page-title-main">Triangular fibrocartilage</span> Anatomical feature in the wrist

The triangular fibrocartilage complex (TFCC) is formed by the triangular fibrocartilage discus (TFC), the radioulnar ligaments (RULs) and the ulnocarpal ligaments (UCLs).

<span class="mw-page-title-main">Articular capsule of the knee joint</span>

The articular capsule of the knee joint is the wide and lax joint capsule of the knee. It is thin in front and at the side, and contains the patella, ligaments, menisci, and bursae of the knee. The capsule consists of an inner synovial membrane, and an outer fibrous membrane separated by fatty deposits anteriorly and posteriorly.

<span class="mw-page-title-main">Genu recurvatum</span> Orthopedic deformity

Genu recurvatum is a deformity in the knee joint, so that the knee bends backwards. In this deformity, excessive extension occurs in the tibiofemoral joint. Genu recurvatum is also called knee hyperextension and back knee. This deformity is more common in women and people with familial ligamentous laxity. Hyperextension of the knee may be mild, moderate or severe.

Posterolateral corner injuries of the knee are injuries to a complex area formed by the interaction of multiple structures. Injuries to the posterolateral corner can be debilitating to the person and require recognition and treatment to avoid long term consequences. Injuries to the PLC often occur in combination with other ligamentous injuries to the knee; most commonly the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL). As with any injury, an understanding of the anatomy and functional interactions of the posterolateral corner is important to diagnosing and treating the injury.

<span class="mw-page-title-main">Medial knee injuries</span> Medical condition

Medial knee injuries are the most common type of knee injury. The medial ligament complex of the knee consists of:

<span class="mw-page-title-main">Vaginal support structures</span> Structures that maintain the position of the vagina within the pelvic cavity

The vaginal support structures are those muscles, bones, ligaments, tendons, membranes and fascia, of the pelvic floor that maintain the position of the vagina within the pelvic cavity and allow the normal functioning of the vagina and other reproductive structures in the female. Defects or injuries to these support structures in the pelvic floor leads to pelvic organ prolapse. Anatomical and congenital variations of vaginal support structures can predispose a woman to further dysfunction and prolapse later in life. The urethra is part of the anterior wall of the vagina and damage to the support structures there can lead to incontinence and urinary retention.

Artificial ligaments are devices used to replace damaged ligaments. Today, the most common use of artificial ligaments is in anterior cruciate ligament reconstruction. Although autotransplantation remains the most common method of ligament reconstruction, numerous materials and structures were developed to optimize the artificial ligament since its creation in the World War I era. Many modern artificial ligaments are made of synthetic polymers, such as polyethylene terephthalate. Various coatings have been added to improve the biocompatibility of the synthetic polymers. Early artificial ligaments developed in the 1980s were ineffective due to material deterioration. Currently, the Ligament Advanced Reinforcement System (LARS) artificial ligament has been utilized extensively in clinical applications. Tissue engineering is a growing area of research which aims to regenerate and restore ligament function.

References

  1. "ligament" at Dorland's Medical Dictionary
  2. Asahara, Hiroshi; Inui, Masafumi; Lotz, Martin K. (September 2017). "Tendons and Ligaments: Connecting Developmental Biology to Musculoskeletal Disease Pathogenesis". Journal of Bone and Mineral Research. 32 (9): 1773–1782. doi:10.1002/jbmr.3199. ISSN   0884-0431. PMC   5585011 . PMID   28621492.
  3. Daniel John Cunningham (1918). Cunningham's text-book of anatomy (5th ed.). Oxford Press. p. 1593.
  4. R.A., Hauser; E.E., Dolan; H.J., Phillips; A.C., Newlin; R.E., Moore; B.A., Woldin (2013-01-23). "Ligament Injury and Healing: A Review of Current Clinical Diagnostics and Therapeutics" (PDF). The Open Rehabilitation Journal. 6 (1): 5. doi: 10.2174/1874943701306010001 .
  5. Lessim S, Migonney V, Thoreux P, Lutomski D, Changotade S (June 2013). "PolyNaSS bioactivation of LARS artificial ligament promotes human ligament fibroblast colonisation in vitro". Biomed Mater Eng. 23 (4): 289–297. doi:10.3233/BME-130753. PMID   23798650.
  6. "Ligament". Physiopedia. Retrieved 2023-09-11.
  7. "Ligament: Anatomy, Function, Sprain". Cleveland Clinic. Retrieved 2023-09-11.