Similar Histopathological Picture in Males with Achilles and Patellar Tendinopathy

Maffulli, Nicola; Testa, Vittorino; Capasso, Giovanni; Ewen, S. W. B.; Sullo, A.; Benazzo, Francesco; King, John B.

doi:10.1249/01.mss.0000139895.94846.8d

Cited by 120 publications

(98 citation statements)

References 24 publications

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“…Two scoring systems can be used for classification of the histopathological findings of tendinopathy: the Movin score [27] and its validated modifications [17,20,25] and the Bonar score [3].…”

Section: Discussionmentioning

confidence: 99%

“…Also, the two scales were originally developed for the Achilles tendon (Movin) [27] and the patellar tendon (Bonar) [3]. We have subsequently used the Movin scale for the patellar tendon [25], and to assess the degree of tendinopathy in the rotator cuff [17], and the long head of the biceps tendon [16]. We have demonstrated the Bonar semiquantitative scale [3] can be used in the upper limb as well, and the scale is simple and reproducible.…”

Section: Discussionmentioning

confidence: 99%

“…In the present investigation, only a few specimens showed any evidence of hyalinization. In our previous use of Movin's scale in tendinopathy of the lower limb [20,22,25], we came to realize that hyalinization is seldom present, and it is a poorly reproducible histopathological criterion in tendinopathic samples. For this reason, we proposed to remove this criterion from the assessment scale.…”

Section: Discussionmentioning

confidence: 99%

“…The area of each specimen showing the most advanced pathologic changes was selected, and the worst possible results for each slide were used in this study. The slides were interpreted using the semiquantitative grading scale of Movin [20,25,27] and the Bonar score [3], which assess various aspects of tendon tissue. The whole slide was assessed for areas of increased cellularity.…”

Section: Methodsmentioning

confidence: 99%

“…Over the last decade, several studies have provided the opportunity to develop novel therapeutic strategies [4-9, 17, 19, 23, 26]. While many of the epidemiological and imaging difficulties have been addressed [2,11], relatively few studies have tried to quantify the histopathological findings of tendinopathy [18,20,21], and the histopathological changes are currently described in a subjective or at best semiquantitative fashion [1,12,20,25,27]. This may result in uncertainty about the histopathological findings of tendinopathy, and has produced a lack of diagnostic uniformity among surgical pathologists.…”

Section: Introductionmentioning

confidence: 99%

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Movin and Bonar Scores Assess the Same Characteristics of Tendon Histology

Maffulli

Longo

Franceschi

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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215

190

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The Movin scoring system and its validated modifications and the Bonar scoring system are used to classify the histopathological findings of tendinopathy. We compared the reliability of these two different histopathological evaluation scores of tendon tissue. Tendon samples were harvested from 88 individuals (49 men, 39 women; mean age, 58.2 years) who underwent arthroscopic repair of a rotator cuff tear, and from five male patients who died of cardiovascular events (mean age, 69.6 years). A piece of supraspinatus tendon that was not directly involved in the tear was harvested en bloc within the intact middle portion of the tendon. Using hematoxylin and eosin staining and Alcian blue, slides were assessed using Bonar and Movin scores. The intraclass correlation was 0.921 (confidence interval 95% 0.790-0.963). Movin's and Bonar's scores have a high correlation and assess similar characteristics and variables of tendon abnormalities.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Movin and Bonar Scores Assess the Same Characteristics of Tendon Histology

Maffulli

Longo

Franceschi

et al. 2008

Clinical Orthopaedics &Amp; Related Research

Self Cite

215

190

View full text Add to dashboard Cite

show abstract

Clinical features of patellar tendinopathy and their implications for rehabilitation

Crossley

Thancanamootoo

Metcalf

et al. 2007

Journal Orthopaedic Research

103

110

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This study investigated the clinical features of patellar tendinopathy (PT), with focus on individuals with unilateral and bilateral PT. A cross-sectional study design was employed to compare individuals with unilateral (n = 14) or bilateral (n = 13) PT and those without PT (control, n = 31). Features assessed included thigh strength (normalized peak knee extensor torque) and flexibility (sit-and-reach and active knee extension), calf endurance (heel-rise test), ankle flexibility (dorsiflexion), alignment measures (arch height and leg length difference), and functional measures (hop for distance and 6 m hop test). Groups were matched for age and height; however, unilateral and bilateral PT had greater mass with a higher body mass index (BMI) than control. Also, bilateral PT performed more sport hours per week than both unilateral PT and control. Unilateral PT had less thigh strength than control and bilateral PT, whereas bilateral PT had more thigh flexibility than control and unilateral PT. Both unilateral and bilateral PT had altered alignment measures compared to control. Features that predicted symptoms in PT were lower thigh flexibility and strength, whereas those that predicted function were higher thigh strength and lower ankle flexibility. These findings indicate that unilateral and bilateral PT represent distinct entities, and that thigh strength appears particularly important in PT as it predicted both symptoms and function in PT.

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VGluT2 expression in painful Achilles and patellar tendinosis: Evidence of local glutamate release by tenocytes

Scott

Alfredson

Forsgren

2007

Journal Orthopaedic Research

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The pathogenesis of chronic tendinopathy is unclear. We have previously measured high intratendinous levels of glutamate in patients with tendinosis, suggesting potential roles of glutamate in the modulation of pain, vascular function, and degenerative changes including apoptosis of tenocytes. However, the origin of free glutamate found in tendon tissue is completely unknown. Surgical biopsies of pain-free normal tendons and tendinosis tendons (Achilles and patellar) were examined immunohistochemically using antibodies against vesicular glutamate transporters (VGluT1 and VGluT2), as indirect markers of glutamate release. In situ hybridization for VGluT2 mRNA was also conducted. Specific immunoreactions for VGluT2, but not VGluT1, could be consistently detected in tenocytes. However, there were interindividual variations in the levels of immunoreactivity. The level of immunoreaction for VGluT2 was higher in tendinosis tendons compared to normal tendons (p < 0.05). In situ hybridization of VGluT2 demonstrated that mRNA was localized in a similar pattern as the protein, with marked expression by certain tenocytes, particularly those showing abnormal appearances. Reactivity for VGluT1 and -2 was absent from nerves and vessel structures in both normal and painful tendons. The current data demonstrate that tenocytes may be involved in the regulation of extracellular glutamate levels in tendons. Specifically, the observations suggest that free glutamate may be locally produced and released by tenocytes, rather than by peripheral neurons. Excessive free glutamate is expected to impact a variety of autocrine and paracrine functions important in the development of tendinosis, including tenocyte proliferation and apoptosis, extracellular matrix metabolism, nociception, and blood flow. ß

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Similar Histopathological Picture in Males with Achilles and Patellar Tendinopathy

Cited by 120 publications

References 24 publications

Movin and Bonar Scores Assess the Same Characteristics of Tendon Histology

Movin and Bonar Scores Assess the Same Characteristics of Tendon Histology

Clinical features of patellar tendinopathy and their implications for rehabilitation

VGluT2 expression in painful Achilles and patellar tendinosis: Evidence of local glutamate release by tenocytes

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