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Normal Ligament Structure, Physiology and Function

Bray, Robert C MD* ; Salo, Paul T MD*; Lo, Ian K MD*; Ackermann, Paul PhD; Rattner, J B PhD*; Hart, David A PhD*

Sports Medicine and Arthroscopy Review: September 2005 - Volume 13 - Issue 3 - p 127-135
doi: 10.1097/
Review Article

Skeletal ligaments are well characterized as mechanical stabilizers of diarthrodial joints. New evidence now suggests that the normal regulation of ligament and joint function may occur through a neural and microvascular “axis,” where the physiology of normal ligaments is influenced by heterogeneous cellular, neural, and microvasculature elements. Within ligament tissue, complex networks of cellular processes linked by gap junctions allow the direct cell-to-cell transfer of signaling molecules, whereas sensory innervation and neurovascular reflexes contribute to motor control and affect ligament mechanical properties. The application of new imaging technologies may assist in determining the functional implications of an integrated neural and microvascular axis. Aging and gender related differences in ligament function are also discussed.

From the *McCaig Centre for Joint Injury and Arthritis Research, Department of Surgery, University of Calgary, Calgary, Alberta, Canada; and the †Department of Orthopaedic Science, Karolinska Institutet, Stockholm, Sweden.

Reprints: R. C. Bray, MD, Department of Surgery, University of Calgary, 3330 Hospital Drive, NW Calgary, Alberta Canada T2N (e-mail:

© 2005 Lippincott Williams & Wilkins, Inc.