Sometimes, in order to repair the damage, physical therapy or surgery is also considered. TS: Distention of the digital flexor tendon sheath (DFTS) (tenosynovitis) on a scale of 0 to 5. Dyson, S. Learn more about our services in Vallejo and how we partner with you to create personalized care. J. Muscle Ligaments Tendons J. Your surgeon drills holes into the bones of the upper arm and the forearm, around. OBJECTIVE. The ability of entheses for self-repair is emphasized and a range of enthesopathies common in sport are reviewed (e. Collagen is the main component of the ECM in human tendons and ligaments; therefore, it is also the first natural polymer used to make scaffolds [ 38 ]. 12,25. And while surgery is, unfortunately, often the only treatment offered, the truth is, most tendon and ligament tears aren’t really extreme enough to require invasive orthopedic. The interfacial musculoskeletal diseases as a global burden. Tendon and ligament injuries — sprains, strains, ruptures and tears — occur frequently. Common ligament tears happen in the ankle, knee, wrist, thumb, neck, or back. Conventional MRI and MR arthrography are the imaging modalities. Synthetic material could help heal injured tendons and ligaments. The enthesis displays gradients in tissue organization, composition and mechanical. Tendon disorders are common and lead to significant disability, pain, healthcare cost, and lost productivity. Tendon and ligament injuries — sprains, strains, ruptures and tears — occur frequently. Rotator cuff injuries are often the result of shoulder muscle dysfunction leading to abnormal joint movements that damage the supraspinatus tendon. Whatever your needs, our experts work with you to create personalized care plans and provide comprehensive support throughout your treatment. Pain relievers. Related. Tendons are the soft, band-like tissues that connect muscles. The American Academy of Orthopaedic Surgeons estimates about 2. Any supplements or foods used to promote ligament and tendon healing must consequently support collagen synthesis and repair. Ligaments attach one bone to another. These well-known dietary supplements are responsible for joint, tendon, and ligament health. Tightly bound water molecules bridge the strands of the helix [], stabilising the. Tendons are soft, fibrous tissues that connect muscle to bone. Rotator cuff repair. 24 miles. Current biological strategies to augment tendon repair. Natural materials commonly used for scaffold development include collagen, fibrin, silk, chitosan, hyaluronic acid and alginate [ 1, 34–37 ]. Although ADSCs have been effective in tendon-bone healing in many studies, the exact mechanism remains unclear. This causes pain and a loss of flexibility in the joint. He graduated from Brown University Alpert Medical School in 1985. Glucosamine functions in the formation and repairment of cartilage, improves joint function, and reduces pain. transmission of forces from muscle to bone (reducing work of muscle) Function of ligament. Several researchers 4 – 6, 9 have proposed a correlation between a longitudinal tear in the PBT and chronic lateral ankle-ligament instability. Advancements in arthroscopy have permitted adequate visualization and exposure of the hamstring footprint, thus allowing for an anatomic repair with increased protection of the. A biceps tendon tear can happen at either the shoulder or the elbow. Tingling. OBJECTIVE. Ortved, K. He works in San Mateo, CA and 5 other locations and specializes in Family Medicine. The cartilage and ligaments that unite the proximal wrist are the most prone to injury. Muscles are shock absorbers. A torn ligament or tendon in the foot is an injury that can limit daily activity. When people have inflamed or irritated tendons, they may experience pain, tenderness and mild swelling near the affected. 12. Introduction. 1. Statement of clinical significance: This paper details mechanisms of ligament and tendon healing, as well as attempts to apply stem cells to ligament and tendon healing. The minimally invasive Percutaneous Achilles Repair System (PARS) technique can be used to treat quadriceps, patellar, and Achilles tendon ruptures. Enhanced histologic repair in a central wound in the anterior cruciate ligament with a collagen-platelet-rich plasma scaffold. Autologous conditioned plasma as therapy of tendon and ligament lesions in seven horses. The two ends of the ruptured tendon will then be stitched together. 5 million people suffer from a serious Achilles tendon injury each year, and some 200,000 experience ACL (anterior cruciate ligament) damage in the knee. The American Academy of Orthopaedic Surgeons estimates about 2. Steven Carlow, MD is an orthopedic surgery specialist in Groton, CT. Rotator cuff repair. Open tendon repair. Fusion repair is adopted when arthritis is present at the wrist. Experimental approaches for enhancing tendon repair consist mainly of applying growth factors, singly or in combination, stem cells in native or genetically modified form, and biomaterials, alone or cell-loaded, at the site of tendon damage. Ruptures of the quadriceps and patellar tendons are common in elite and recreational athletes. The condition causes pain and tenderness just outside a joint. Orthopedic Surgery. The enthesis, where the tissue attaches to the bone, is categorized into four zones. Applying an ice pack (to reduce swelling within hours of the injury) Compression, using an elastic bandage or brace. Christopher Hutchins, MD. A torn ligament severely limits knee movement. 3. com. Sprains are caused when a joint is. Vitamin C’s impact on collagen synthesis is so pronounced, vitamin C tendon and ligament supplements decreased pain in patients with tendon injuries by as much as 83%. The ultrasound analyses focussed on changes in lesion echogenicity and its percentage. Achilles tendon rupture is a frequent injury with an increasing incidence. (701) 746-7521. Avulsion of the flexor profundus tendon insertion. 4. The natural healing process of tendon injury is complex. Sutter’s network of 400 orthopedic and sports medicine experts perform more than 10,000 orthopedic procedures a year, placing us among the most experienced providers in Northern California. Anatomic reconstruction with tendon graft should be considered when repair is not possible, as it maintains physiological joint kinematics. You may also hear or feel a pop when you tear the tissue. Tendinitis —Pain, swelling, warmth to the touch. An estimated 300,000 tendon and ligament repair surgeries are performed annually in the U. . See full list on upmc. Tendon/ligament. BPC 157 has received attention as a potential treatment for a number of medical conditions, most notably Inflammatory bowel syndrome and healing of stomach ulcers. Then, we review commonly encountered complications: those associated with decreased range of motion (impingement, arthrofibrosis, intraarticular bodies, ganglion cysts) and those associated. Rest: try to avoid moving the tendon for 2 to 3 days. University of Sydney biomedical engineers have collaborated with Columbia University and the University of Erlangen-Nuremberg to develop a synthetic material to assist in the regeneration of injured tendons and ligaments. There are two main types of tendon and ligament injuries; external injuries and overstrain injuries. Tendon and ligament injuries — sprains, strains, ruptures and tears — occur frequently. Ligaments. Tendons are stronger than muscles and can resist against tensile and compressive forces. Ligament damage often happens from a sports injury. 2 In addition to the economic cost, these injuries also have a significant impact on patients’ quality of life and. Carpal tunnel procedures. Tendons and ligaments (T/L) have transition areas at the boundaries that are highly specialized. You're running or jumping or standing, and too much force transfers to your tendon and WHAM! Tendon Tear !The Tenodesis screw may be used in conjunction with #2 or 2-0 FiberWire® suture to facilitate intraoperative tissue tensioning and fixation in a predrilled socket. Ligaments and tendons are fibrous tissues with poor vascularity and limited regeneration capacity. the tendon crimp, decreases the number of fascicles, and increases the thickness of the endotenon. Dr. Many different types of surgeries are available for rotator cuff injuries, including: Arthroscopic tendon repair. A tendon from the kneecap or hamstring, for example, is grafted into place to hold the knee joint together. 24078497. 5 million people suffer from a serious Achilles tendon injury each year, and some 200,000 experience ACL (anterior cruciate ligament) damage in the knee. The anterior cruciate ligament (ACL) is located toward the front of the knee. Briefly, surgical interventions and biophysical stimulation are currently employed in clinical care. In addition, there are some other minor anatomical differences. Tendon and ligament injuries — sprains, strains, ruptures and tears — occur frequently. However, the complexity underpinning these interactive multifactorial elements is still not fully characterised. The tendons are freed and mobilized, the ischial tuberosity is decorticated, and an anatomic repair is performed via 4 suture anchors, 2 at each tendon footprint. Tendons are attached to muscles and to bone. Lateral ankle ligament reconstruction is a surgery to tighten and firm up one or more ankle ligaments on the outside of your ankle. Type I collagen from both tendon and ligaments shared a similar 3-hydroxyproline profile attributable to P3H1 [43] and P3H2 [33], [44]. August 30, 2023. Partial Tendon and Ligament Tears. Both the cases and controls may harbour genetic and non-genetic elements, which may confer an increased or decreased risk to sustaining a potential tendon or ligament injury. Symptoms. Injury to the anterior cruciate ligament (ACL) is among the most common orthopaedic injuries, and reconstruction of a ruptured ACL is a common orthopaedic procedure. Restricted range of motion. Non-members, please Click here for details on how to join. Overstretching, tearing, rupture, or bruising are the most typical physical injuries that can occur. To create Tough Gel Adhesives tailored to tendon regeneration, “we forward-engineered an alginate-polyacrylamide-based hydrogel into a two-sided biomaterial, essentially, by modifying one of its surfaces with a sugar known as chitosan, which we showed allows firm bonding to tendons. Then, we review commonly encountered complications: those associated with decreased range of motion (impingement, arthrofibrosis, intraarticular bodies, ganglion cysts) and those associated with laxity (graft tearing, graft stretching). The tarsal bones are found near the. Activity limitations. , 2011). Each muscle has two tendons, one proximally and one distally. For example, collagen content of Achilles tendons from postnatal day (P)4 mice is less than 3% of the dry weight [], and in 1 week old sheep, cells account for nearly 33% of the tendon. A potential disadvantage of tendon/ligament repair in clinical trials is that this method requires tearing down the intact tendon/ligament tissue, which may result in a length-tension mismatch in the repaired cuff and alter the normal orientation, and shape . A number of arteries may be responsible for contributing to the blood supply of a tendon. A sprain is an injury to the ligaments which are soft tissue structures that stabilize a joint. J Trauma. They cross each other to create an X. The American Academy of Orthopaedic Surgeons estimates about 2. He graduated from Johns Hopkins School of Medicine in 1994. A tear can also be complete or partial. 7. 1 Introduction. Our goal is to get you back in the game. BOOK APPOINTMENT. They have a very high collagen content, mostly Type I collagen [], arranged in a cross-linked triple-helix structure [2,3]. ACL reconstruction. , 2021). (860) 449-1413. On average, hand injuries count for 14% to 30% of all treated patients in emergency care. Tendon vs Ligament. Most surgeons treat these injuries surgically to lessen the risk of long-term disability and morbidity. The ligament, located in the center of the knee, that controls rotation. 18-11. The fascicles combine to form tendon tissues. Dr. Flexor tendon injuries typically occur from a cut on the palm side of your fingers, hand, wrist, or forearm. Your surgeon drills holes into the bones of the upper arm and the forearm, around the elbow joint. Rotator cuff repair. He is affiliated with Lawrence and Memorial Hospital. Initially, 1 to 5 days post-injury, an inflammatory response occurs in which. Tendons and ligaments are connective tissues that help support muscles and bones. 4, overview of tendon structure), early studies showed that rabbit MSCs contract collagen type I carrier gels and that the delivery of these constructs to patellar and Achilles tendon defects improved the biomechanical properties of the repair tissue as compared to acellular controls [375]. Tendon and ligament are hierarchical structures with an organization that builds from the nanoscale to the centimeter scale, based primarily on the built-up form of type I collagen (Fig. They vary in size, location, shape, and orientation. What is a posterior tibialis tendon repair? To prevent further collapse of the arch, a repair must be performed. Tendons are anatomical structures connecting muscles to bones which generate transmission of forces, thereby ensuring joint movements. 3. Outlook Doctors carry out tendon repair surgery to fix a tendon injury. Abstract. There are relatively few of these cells compared to the amount of collagen in a tendon or ligament, and that’s one reason why these injuries heal slowly. Illustrated tendon and ligament for knee joint were shown in. An inability to bend the foot downward or "push off" the injured leg when walking. Tendons and ligaments play a significant role in providing the joint function and overall musculoskeletal biomechanics. Abstract. An inversion injury to the ankle may thus not only produce ligament damage to the anterior talofibular and calcaneofibular ligaments but also injury. The predominant solution is the suture thread, which is not without potential side effects and limitations. It’s a type of surgery for treating arthritis of the thumb, a common type of arthritis in the hand. This means it hasn’t torn completely through. Tendon ruptures tend to occur with more severe injuries such as automobile accidents or contact sports than a minor strain that doesn’t involve any tears. This article provides a review of anterior cruciate ligament (ACL) reconstruction procedures and their normal postoperative appearance. Overview of Tendon Mending Pills. Tendons and ligaments are force-transferring tissues from muscle to bone and bone to bone, respectively. The American Academy of Orthopaedic Surgeons estimates about 2. 55 ± 8. The anterior talofibular ligament (ATFL) is the most frequently injured ligament in ankle sprains. Tendons attach a muscle to a bone. Your ankle is a hinge joint that allows motion up and down, and from side to side. His office accepts new patients and telehealth appointments. Signs and symptoms of a sprained ankle vary depending on the severity of the injury. Tendons attach muscles to bones. 4, 425–432 (2014). Swelling. Recovery can take up to 12 weeks. There are specialized areas of tendon and ligament at their at-tachments. Sutter network surgeons offer a number of different tendon and ligament repair surgeries, such as: Achilles tendon repair. We will first review recent work on tendon embryology and discuss ligament formation, which has been less documented. ACL reconstruction. , a knife injury). In addition to surgery, the service also performs diagnostic. The two peroneal tendons in the foot run side by side behind the outer ankle bone. Tendon and Ligament Repair Ligament and tendon injuries are common, especially among athletes, and they can cause significant pain and loss of mobility. However, after surgery, there are still many. . The American Academy of Orthopaedic Surgeons estimates about 2. Tendons. It is one of the important joints of the upper limb and is involved in basic movements such as flexion and extension of the upper limb. The protein, Secreted Protein Acidic and Rich in. Tendons are predominantly composed of collagen, which is. F. Tendon and ligament fibers can become damaged from trauma or overuse injuries and are slower to heal than muscle fibers due. Overuse injuries (including tendon and ligaments) account for 7% of all doctor visits in the USA. Therefore, surgeries are necessary and also widely used to treat ligament/tendon or cartilage injuries. 11138/mltj. Ice: Put an ice pack or cold compress on your foot for up to 20 minutes at a time. Tendon and Ligament Structure and Healing. The predominant solution is the suture thread, which is not without potential. The current management options fail to restore the preinjury. Tendon disorders are common and lead to significant disability, pain, healthcare cost, and lost productivity. Common tendon repair surgeries include: Foot and ankle tendon repair including reattaching a ruptured Achilles tendon. 5 million people suffer from a serious Achilles tendon injury each year, and some 200,000 experience ACL (anterior cruciate ligament) damage in the knee. It improves the quality of tendon healing by. Sutter network surgeons offer a number of different tendon and ligament repair surgeries, such as: Achilles tendon repair. Sen: Response to digital palpation of a tendon or ligament on a scale of 0 to 5. There are also many unnamed fibrous connections linking tendons and ligaments directly together near their. An evaluation of the quadriceps tendon revealed a partial tear of 50% of the deep portion near the insertion site at the superior pole of the knee. Common symptoms of tendinosis are: localized burning pain and. Ligament/tendon and cartilage injuries are clinically common diseases that perplex most clinicians. Much of the research has examined that when the damaged area receives near-infrared light with a length of 600–1,000 nm and a radiation value of 3–10 J/cm 2, it normally promotes tendon repair to a large extent. When using lemongrass, do not apply to open cuts or wounds as it will irritate the raw skin. 40 Years Experience. Musculoskeletal disease and injury, now and in the future. Tears or ruptures to tendons and ligaments can: Cause extreme pain. Tendon development involves multiple germ layer, as well as the regulation of diversity transcription factors (Scx et al. tendons M66. Hand tendon repair is needed when 1 or more tendons in your hand rupture (break or split) or are cut, leading to the loss of normal hand movements. Tendon and/or ligaments such as the rotator cuff tendons (shoulder), the anterior cruciate ligament (ACL; knee), and the Achilles tendon (ankle) are some of the more common sites of musculoskeletal injuries during both competitive and recreational sporting activities. Elbow Ligaments – you also have three primary ligaments that are located near your. They account for 45% of the 32 million musculoskeletal injuries each year in the United States (Butler, Juncosa, & Dressler, 2004), with rates rising due to contact sports participation and the aging population. Hip tendonitis is painful inflammation or irritation of a tendon in the hip. Regenerative Medicine for Tendon and Ligament Repair Healing of tendons and ligaments is more difficult than healing of tissue in other parts of the body. Torn or stretched ligaments are also called sprains. Sutter network surgeons offer a number of different tendon and ligament repair surgeries, such as: Achilles tendon repair. In the first study, published in the Journal of Orthopaedic Research, Cedars-Sinai scientists showed that specialized engineered stem cells called induced pluripotent stem cell-derived mesenchymal stromal cells (iMSCs) can regenerate and repair the tendon more effectively than other types of cells. Ligament injuries such as anterior cruciate ligament (ACL) tears are very common in sports and stem cell-based therapies have been shown to promote ligament and tendon-to-bone repair [6, 8,9,10]. If the ligament is still mostly healthy, the surgeon can do the repair using only the. Using iMSCs to Repair Tendon and Ligaments. Recovering from Tendon Repair SurgeryFormalPara Learning Outcomes . , 2008; Connizzo et al. Our goal is to get you back in the game. The division of tendons into fibrils ensures that minor damage does not necessarily spread to the entire tendon, and also provides a high total structural strength . His office accepts new patients and telehealth appointments. Although sixty-five (55. 5 million people suffer from a serious Achilles tendon injury each year, and some 200,000 experience ACL (anterior cruciate ligament) damage in the knee. Our goal is to get you back in the game. 4 [95% CI, 0. Tendon structure and composition. This could potentially be Tendonitis in elbow. An incision may be made in your hand to make the wound larger. Tissue engineering represents an alternative solution for good tissue integration and. 508-887-4794. They vary in size, location, shape, and orientation. More than one ligament or the fibrous cartilage in your knee also is injured; The injury is causing your knee to buckle during everyday activities; During ACL reconstruction, the surgeon removes the damaged ligament and replaces it with a segment of tendon — tissue similar to a ligament that connects muscle to bone. As dense connective tissues connecting bone to muscle and bone to bone, respectively, tendon and ligament (T/L). The main purpose of chronic tendon injury treatment is to reduce pain, mainly through local or systemic anti-inflammatory drugs, while treatment of acute tendon injuries aims to repair broken tendons with surgical techniques (3, 34, 35). 54. The ATFL remnant is carefully dissected only at the footprint of the superior limb of the ATFL,. Tendinitis is graded as moderate if the tendon CSA is 20–35% greater than the estab-lished normal range for the affected site(s) or than SDF CSA of the opposite limb at the same site(s); if any core lesion seen is 15–30% of the total tendon CSA; and if the affected area extends 20–35% of the length of the tendon. For centuries, the Chinese Gua sha technique has been used to promote healing by scraping muscle tissue to stimulate blood flow. ),. What are the symptoms of a biceps tendon tear?Tendon and ligament regeneration and repair: clinical relevance and developmental paradigm. The enthesis, where the tissue attaches to the bone, is categorized into four zones. S (Pennisi, 2002). Therefore, surgeries are necessary and also widely used to treat ligament/tendon or cartilage injuries. 1]; P ≥ . They usually occur due to extreme force to a joint, such as with a fall or another high-impact event. It has been estimated that in the United States, flexor tendon lacerations cost the medical system $240. Overstrain injuries occur in two main ways. 8%) of these cases. swelling. Treatment of Tendon Injuries. ACL reconstruction. If a knee ligament is torn, additional treatment might include: Muscle-strengthening exercises. In fact, a frequently used surgical intervention to repair torn or injured ligaments is tendon auto- or allografting (Kan et al. Each type of injury or degeneration can cause substantial pain and the loss of tendon function. Embryonic and early stage postnatal tendon is highly cellular and collagen content is relatively low, compared to adult tendon [26, 27, 29, 51, 59, 60]. Email: Info@OldTownStrings. Our goal is to get you back in the. Lateral ankle ligament reconstruction is a surgical procedure to tighten and secure one or more ankle ligaments on the outside of your ankle. (925) 397-8992. ligament with a blunt-ended bistoury (tenotomy) knife. The point at which the tendon forms attachment to the muscle is also known as the myotendinous junction. Methods of repair focus on reapposition of tendon or ligament ends, resistance to gap formation during the repair phase of healing, and production of a repair with adequate stiffness and strength to resist recurrence following return to preinjury activities. This level of injury typically takes 6 to 12 weeks to heal and may require more extensive physical therapy. The American Academy of Orthopaedic Surgeons estimates about 2. About 16. 8 to $409. (B) Triple-helical type I collagen molecules aggregate to form collagen fibrils, which further assemble into fascicles. 3 Teaching Points Ligaments are elastic bands of tissue that connect bones to each other and provide stability and strength to the joint. But research has shown benefits for musculoskeletal injuries, such as injuries of tendons and ligaments, muscle injuries, nerve injuries, bone fractures, tendinopathies like tennis. Background: Tendon and ligament injuries accounted for 30% of all musculoskeletal consultations with 4 million new incidences worldwide each year and thus imposed a significant burden to the society and the economy. Cellular cues. Elbow tendonitis is common with many professions. Doctors perform tendon repair surgery to fix a tendon injury. Whatever your needs, our experts work with you to create personalized care plans and provide comprehensive support throughout your treatment. 4 million tendon and ligament injuries occur in the United States every year2 and the incident rate of TLIs is expected to rise drastically as the population ages and remains active. Joints are formed where two. Tendons are specialised, heterogeneous connective tissues, which represent a significant healthcare challenge after injury. The surgery to correct a torn knee ligament involves replacing the ligament with a piece of healthy tendon. The natural healing process of tendon injury is complex. They have specialized zones (at the myotendinous junction for tendons and at the insertion to bone for both), which. It stabilizes the leg under full weight-bearing load and prevents the fetlock from falling. Tendons contain bundles of fiber, which a type of. 2 This can mean the end of a career for many horses. The anterior cruciate ligament and the medial collateral ligament are the most studied intra-articular and extra-articular ligaments, and both are associated. Rotator cuff repair. Facilitation of healing of tendons and ligaments. Ligaments that become overstretched or torn are technically “sprained. Tendon and ligament injuries — sprains, strains, ruptures and tears — occur frequently. 5 million people suffer from a serious Achilles tendon injury each year, and some 200,000 experience ACL (anterior cruciate ligament) damage in the knee. . Tendon and ligament injuries — sprains, strains, ruptures and tears — occur frequently. This causes pain and a loss of flexibility in the joint. Successful anterior cruciate ligament reconstruction with a tendon graft necessitates solid healing of the tendon graft in the bone tunnel. They are load-bearing structures, with tendons transmitting forces from muscle to bone and ligaments transmitting forces from bone to bone. A study by The University of Western Australia (UWA), Perron Institute, Paracelsus Medical University (Austria) and Nanjing University (China) has identified a protein that reacts to stresses on tendons and ligaments and plays a key role in how our body responds to them. 1990. A tendon graft might be needed if your tendon or ligament is severely injured. The American Academy of Orthopaedic Surgeons estimates about 2. This procedure involves replacing the torn ligament with a tendon graft. Pain, possibly severe, and swelling near the heel. Tendon and ligament injuries — sprains, strains, ruptures and tears — occur frequently. Scaffolds have been used for mechanical and biologic reinforcement of repair and regeneration with mixed results. Tarsals. Use a compression bandage to wrap the affected area to prevent movement and help prevent swelling. Eaton et al. Extensive research continues to further understand the complex healing pathways that are involved when these structures are damaged. Chondroitin helps maintain the function of tissues such as tendons and ligaments and possesses anti. Normal and Healing Ligaments and Tendons. Tendons and ligaments connect muscles to bone or bone to bone, respectively, which enable locomotion, and the interface where tendon or ligament attaches to bone is known as the enthesis [1, 2]. 09 N) than in. Tendon and ligament lesions don’t always heal properly, as scar tissue can be less elastic than healthy tissue, and reinjury rates can be up to 80 percent. The ligament has been slightly stretched, but the knee joint is stable. Equine Vet J. 2013 Sep;99 (3):203-222. If your extensor tendons are damaged, you'll be unable to straighten 1 or more fingers. An example is a twisting knee injury in basketball or skiing. , during a high speed or high impact event) or lacerated (e. Human doctors have cruciate ligament (which stabilizes the knee joint) surgical repair down to an exact science these days, which involves taking a nearby tendon and attaching it to the knee where. doi: 10. Rindermann G, Cislakova M, Arndt G, Carstanjen B. Practice Essentials. 6. However, the healing of injured flexor tendons is stretched over a long period of up to 12 weeks, therefore, remaining a significant clinical problem. Whatever your needs, our experts work with you to create personalized care plans and provide comprehensive support throughout your treatment. This includes models addressing the roles of (1) fibril-forming collagens as well as interacting molecules regulating tendon fibrillogenesis; (2) growth factors and their receptors; (3) transcription factors and (4) cell surface receptors. A ligament is fibrous tissue that connects 2 or more bones together. "Call for appointment: 410-448-6400. If your flexor tendons are damaged, you will be unable to bend one or more of your fingers. As tendon and ligament (T&L) tissue is mainly composed of collagen (Sharma and Maffulli, 2006), it is self-evident that many approaches aiming at tendon reconstructions are based on collagen. Old Town Strings ::: Instrument Repairs & Restoration ::: Victoria BC. Material-structural correlations in ligaments and tendons.