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Tendon Healing

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Abstract

The principles governing tendon healing after injury have been well described in the current literature. While basic science research has pioneered our understanding of the tendon healing response, recent innovative clinical studies have further advanced our comprehension of the healing process. These novel ideas aim to optimize healing of the injured tendon through modulation of growth factors, mesenchymal cells, and by altering post-injury rehabilitation protocols. A thorough evaluation of the current literature is included in the chapter to help the treating physician understand the mechanism of tendon healing and potentially optimize the treatment of tendon pathology.

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References

  • Behera P, Dhillon M, Aggarwal S, Marwaha N, Prakash M (2015) Leukocyte-poor platelet-rich plasma versus bupivacaine for recalcitrant lateral epicondylar tendinopathy. J Orthop Surg 23(1):6–10

    Article  Google Scholar 

  • Bhole AP, Flynn BP, Liles M, Saeidi N, Dimarzio CA, Ruberti JW (2009) Mechanical strain enhances survivability of collagen micronetworks in the presence of collagenase: implications for load-bearing matrix growth and stability. Philos Transact A Math Phys Eng Sci 367(1902):3339–3362

    Article  CAS  Google Scholar 

  • Bring DK, Reno C, Renstrom P, Salo P, Hart DA, Ackermann PW (2009) Joint immobilization reduces the expression of sensory neuropeptide receptors and impairs healing after tendon rupture in a rat model. J Orthop Res 27(2):274–280

    Article  CAS  PubMed  Google Scholar 

  • Brkljac M, Kumar S, Kalloo D, Hirehal K (2015) The effect of platelet-rich plasma injection on lateral epicondylitis following failed conservative management. J Orthop 12(Suppl 2):S166–S170

    Article  PubMed  PubMed Central  Google Scholar 

  • Bunker DL, Ilie V, Ilie V, Nicklin S (2014) Tendon to bone healing and its implications for surgery. Muscles Ligaments Tendons J 4(3):343–350

    PubMed  PubMed Central  Google Scholar 

  • Butler DL, Juncosa N, Dressler MR (2004) Functional efficacy of tendon repair processes. Annu Rev Biomed Eng 6:303–329

    Article  CAS  PubMed  Google Scholar 

  • Carr AJ, Murphy R, Dakin SG et al (2015) Platelet-rich plasma injection with arthroscopic acromioplasty for chronic rotator cuff tendinopathy: a randomized controlled trial. Am J Sports Med 43(12):2891–2897

    Article  PubMed  Google Scholar 

  • Chen X, Song XH, Yin Z et al (2009) Stepwise differentiation of human embryonic stem cells promotes tendon regeneration by secreting fetal tendon matrix and differentiation factors. Stem Cells 27(6):1276–1287

    Article  CAS  PubMed  Google Scholar 

  • Crescibene A, Napolitano M, Sbano R, Costabile E, Almolla H (2015) Infiltration of Autologous Growth Factors in Chronic Tendinopathies. J Blood Transfus 2015:924380

    PubMed  PubMed Central  Google Scholar 

  • De Carli A, Lanzetti RM, Ciompi A et al (2016) Can platelet-rich plasma have a role in Achilles tendon surgical repair? Knee Surg Sports Traumatol Arthrosc 24(2237):2231–2237

    Google Scholar 

  • Dyment NA, Kazemi N, Aschbacher-Smith LE et al (2012) The relationships among spatiotemporal collagen gene expression, histology, and biomechanics following full-length injury in the murine patellar tendon. J Orthop Res 30(1):28–36

    Article  CAS  PubMed  Google Scholar 

  • Filardo G, Di Matteo B, Kon E, Merli G, Marcacci M (2016) Platelet-rich plasma in tendon-related disorders: results and indications. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-016-4261-4

    Google Scholar 

  • Flynn BP, Bhole AP, Saeidi N, Liles M, Dimarzio CA, Ruberti JW (2010) Mechanical strain stabilizes reconstituted collagen fibrils against enzymatic degradation by mammalian collagenase matrix metalloproteinase 8 (MMP-8). PLoS One 5(8):e12337

    Article  PubMed  PubMed Central  Google Scholar 

  • Galloway MT, Lalley AL, Shearn JT (2013) The role of mechanical loading in tendon development, maintenance, injury, and repair. J Bone Joint Surg Am 95(17):1620–1628

    Article  PubMed  PubMed Central  Google Scholar 

  • Galvez MG, Crowe C, Farnebo S, Chang J (2014) Tissue engineering in flexor tendon surgery: current state and future advances. J Hand Surg Eur Vol 39(1):71–78

    Article  CAS  PubMed  Google Scholar 

  • Gelberman RH, Chu CR, Williams CS, Seiler JG 3rd, Amiel D (1992) Angiogenesis in healing autogenous flexor-tendon grafts. J Bone Joint Surg Am 74(8):1207–1216

    Article  CAS  PubMed  Google Scholar 

  • Gelberman RH, Vande Berg JS, Lundborg GN, Akeson WH (1983) Flexor tendon healing and restoration of the gliding surface. An ultrastructural study in dogs. J Bone Joint Surg Am 65(1):70–80

    Article  CAS  PubMed  Google Scholar 

  • Hogan MV, Bagayoko N, James R, Starnes T, Katz A, Chhabra AB (2011) Tissue engineering solutions for tendon repair. J Am Acad Orthop Surg 19(3):134–142

    Article  PubMed  Google Scholar 

  • Holladay C, Abbah SA, O’Dowd C, Pandit A, Zeugolis DI (2016) Preferential tendon stem cell response to growth factor supplementation. J Tissue Eng Regen Med 10(9):783–798

    Article  CAS  PubMed  Google Scholar 

  • Hyman J, Rodeo SA (2000) Injury and repair of tendons and ligaments. Phys Med Rehabil Clin N Am 11(2):267–288, v

    CAS  PubMed  Google Scholar 

  • Karousou E, Ronga M, Vigetti D, Passi A, Maffulli N (2008) Collagens, proteoglycans, MMP-2, MMP-9 and TIMPs in human achilles tendon rupture. Clin Orthop Relat Res 466(7):1577–1582

    Article  PubMed  PubMed Central  Google Scholar 

  • Lin TW, Cardenas L, Soslowsky LJ (2004) Biomechanics of tendon injury and repair. J Biomech 37(6):865–877

    Article  PubMed  Google Scholar 

  • Maganaris CN, Narici MV, Almekinders LC, Maffulli N (2004) Biomechanics and pathophysiology of overuse tendon injuries: ideas on insertional tendinopathy. Sports Med 34(14):1005–1017

    Article  PubMed  Google Scholar 

  • Molloy T, Wang Y, Murrell G (2003) The roles of growth factors in tendon and ligament healing. Sports Med 33(5):381–394

    Article  PubMed  Google Scholar 

  • Muller SA, Todorov A, Heisterbach PE, Martin I, Majewski M (2015) Tendon healing: an overview of physiology, biology, and pathology of tendon healing and systematic review of state of the art in tendon bioengineering. Knee Surg Sports Traumatol Arthrosc 23(7):2097–2105

    Article  PubMed  Google Scholar 

  • Nabeshima Y, Grood ES, Sakurai A, Herman JH (1996) Uniaxial tension inhibits tendon collagen degradation by collagenase in vitro. J Orthop Res 14(1):123–130

    Article  CAS  PubMed  Google Scholar 

  • Noyes FR, DeLucas JL, Torvik PJ (1974) Biomechanics of anterior cruciate ligament failure: an analysis of strain-rate sensitivity and mechanisms of failure in primates. J Bone Joint Surg Am 56(2):236–253

    Article  CAS  PubMed  Google Scholar 

  • Oliva F, Via AG, Maffulli N (2011) Role of growth factors in rotator cuff healing. Sports Med Arthrosc Rev 19(3):218–226

    Article  Google Scholar 

  • Sammer DM, Chung KC (2014) Advances in the healing of flexor tendon injuries. Wound Repair Regen 22(Suppl 1):25–29

    Article  PubMed  Google Scholar 

  • Schizas N, Li J, Andersson T et al (2010) Compression therapy promotes proliferative repair during rat Achilles tendon immobilization. J Orthop Res 28(7):852–858

    PubMed  Google Scholar 

  • Sciore P, Boykiw R, Hart DA (1998) Semiquantitative reverse transcription-polymerase chain reaction analysis of mRNA for growth factors and growth factor receptors from normal and healing rabbit medial collateral ligament tissue. J Orthop Res 16(4):429–437

    Article  CAS  PubMed  Google Scholar 

  • Sharma P, Maffulli N (2005) Tendon injury and tendinopathy: healing and repair. J Bone Joint Surg Am 87(1):187–202

    PubMed  Google Scholar 

  • Sharma P, Maffulli N (2006) Biology of tendon injury: healing, modeling and remodeling. J Musculoskelet Neuronal Interact 6(2):181–190

    CAS  PubMed  Google Scholar 

  • Strickland JW (2000) Development of flexor tendon surgery: twenty-five years of progress. J Hand Surg Am 25(2):214–235

    Article  CAS  PubMed  Google Scholar 

  • Valkering KP, Aufwerber S, Ranuccio F, Lunini E, Edman G, Ackermann PW (2016) Functional weight-bearing mobilization after Achilles tendon rupture enhances early healing response: a single-blinded randomized controlled trial. Knee Surg Sports Traumat Arthrosc. doi:10.1007/s00167-016-4270-3

    Google Scholar 

  • Wang JH (2006) Mechanobiology of tendon. J Biomech 39(9):1563–1582

    Article  PubMed  Google Scholar 

  • Wurgler-Hauri CC, Dourte LM, Baradet TC, Williams GR, Soslowsky LJ (2007) Temporal expression of 8 growth factors in tendon-to-bone healing in a rat supraspinatus model. J Shoulder Elbow Surg 16(5 Suppl):S198–S203

    Article  PubMed  PubMed Central  Google Scholar 

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Pauyo, T., Herbst, E., Fu, F.H. (2017). Tendon Healing. In: Canata, G., d'Hooghe, P., Hunt, K. (eds) Muscle and Tendon Injuries. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-54184-5_4

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  • DOI: https://doi.org/10.1007/978-3-662-54184-5_4

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-54183-8

  • Online ISBN: 978-3-662-54184-5

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