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2015 ; 33
(6
): 832-9
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Mechanisms of tendon injury and repair
#MMPMID25641114
Thomopoulos S
; Parks WC
; Rifkin DB
; Derwin KA
J Orthop Res
2015[Jun]; 33
(6
): 832-9
PMID25641114
show ga
Tendon disorders are common and lead to significant disability, pain, healthcare
cost, and lost productivity. A wide range of injury mechanisms exist leading to
tendinopathy or tendon rupture. Tears can occur in healthy tendons that are
acutely overloaded (e.g., during a high speed or high impact event) or lacerated
(e.g., a knife injury). Tendinitis or tendinosis can occur in tendons exposed to
overuse conditions (e.g., an elite swimmer's training regimen) or intrinsic
tissue degeneration (e.g., age-related degeneration). The healing potential of a
torn or pathologic tendon varies depending on anatomic location (e.g., Achilles
vs. rotator cuff) and local environment (e.g., intrasynovial vs. extrasynovial).
Although healing occurs to varying degrees, in general healing of repaired
tendons follows the typical wound healing course, including an early inflammatory
phase, followed by proliferative and remodeling phases. Numerous treatment
approaches have been attempted to improve tendon healing, including growth
factor- and cell-based therapies and rehabilitation protocols. This review will
describe the current state of knowledge of injury and repair of the three most
common tendinopathies--flexor tendon lacerations, Achilles tendon rupture, and
rotator cuff disorders--with a particular focus on the use of animal models for
understanding tendon healing.