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Muscle, Ligaments and Tendons Journal

Ligaments vs tendons in joint reconstruction: a review of histology and biomechanics

Original Article, 246 - 254
doi: 10.11138/mltj/2018.8.2.246
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Abstract
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Introduction: In the current literature, there is no consensus of using tendons vs ligaments as a graft source for joint reconstruction. The aim of this review is to determine the potential superiority of tendons vs ligaments in joint reconstruction.
Methods: A literature search was performed to find relevant articles exploring the properties of tendons and ligaments. Functional, structural (gross and histological), biochemical, and biomechanical properties were compared.
Results: Tendons have a stiffer structure to hold muscle to bone whereas ligaments have a more elastic structure to allow for movement between bones. Ligaments have a narrower crimp distance, ovoid cells, and a higher concentration of alpha smooth muscle associated with higher elasticity and tolerated strain. It has been shown that tendons undergo “ligamentization” when used to reconstruct ligaments. However, even after remodelling, important differences still persist, never reaching the functional status of the intact ligament.
Conclusions: There is a theoretical clinical advantage of using ligaments as a graft source in complex multiaxial joints where stretching and full range of motion (ROM) is crucial (e.g. radiocarpal, carpal joints). Tendon grafts may be more desirable in lower limb reconstructions and in mainly uniaxial joints where excessive and constant vector of stress is applied. Level of evidence: IIIa.

Vol. 8 (No. 4) 2018 October/December

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