Biochemical Causes of Patellar Tendinopathy?

Abstract

In conclusion, evidence points in a new direction: that biochemical mediators, deriving from nerves in or around the patellar tendon or from the tendon tissue itself, may profoundly influence the nerves, blood vessels, and tenocytes in patellar tendon tissue. The findings furthermore suggest that these phenomena arise or increase in response to patellar tendinopathy, or even precede/elicit the condition, as they are only rarely or very moderately seen in normal patellar tendons. Thus, the ramifications of neuronal or non-neuronal biochemical mediators in patellar tendinopathy include effects on tendon tissue (tendinosis changes), vascular regulation, and/or pain signalling. Clinical use of this knowledge in the future might be of potentially high impact. If the model of biochemical pathogenesis/pathology in patellar tendinopathy proves to have some validity, it would mean that clinical management would aim to modify the biochemical milieu, rather than just focusing on collagen repair. Eccentric training regimens and surgery would probably still have their uses, but researchers would be encouraged to pursue a pharmaceutical approach focused on reducing the irritant biochemical compounds in or around the tendon, if proven to be a causative factor in tendinopathy. This would actually mean that treatments might challenge the cause, rather than only the symptoms or consequences, of tendinopathy development.