Tendinopathies of the Elbow, Wrist, and Hand: Histopathology and Clinical Considerations

Fedorczyk, Jane M.

doi:10.1016/j.jht.2011.12.001

Cited by 30 publications

(24 citation statements)

References 69 publications

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“…La tendinosis es un término utilizado para describir los cambios morfológicos y estructurales descritos en tendinopatías crónicas,con o sin presencia de sintomatología en los pacientes, así como lo muestran estudios histopatológicos de rupturas espontaneas de tendones . 2,6 Los hallazgos patológicos más comunes asociados con la tendinopatía no insercional son la tendinosis y la paratendinopatía. 7 La tendinosis comprende cambios patológicos como la desorganización y separación de las fibras de colágeno, el aumento de la sustancia fundamental mucoide, la hipercelularidad y la neovascularización, en su mayoría sin signos de inflamación intratendinosa.…”

Section: Cambios Histológicos Del Tendónunclassified

“…Otras fibras nerviosas penetran a través de las vainas de tejido conjuntivo hasta la superficie del tendón, y finalizan en las terminaciones nerviosas sensitivas, las cuales son consideradas como órganos sensitivos de la coordinación, control motor y mediación de dolor. 2 El aporte vascular se localiza en la unión miotendinosa, unión osteotendinosa y peritendón, por lo tanto, se puede entender que la vascularización de un tendón maduro es muy pobre, por lo que al ser un tejido poco vascularizado tiene limitadas en las medidas de reparación ante las tendinopatías.…”

Section: Introductionunclassified

“…Resulta ser un problema clínico común y conlleva un impacto en la calidad de vida de las personas. 2 Su etiología es de origen multifactorial, y no se comprende del todo bien. 3 Se han descritos distintos factores de riesgo, a menudo en dos principales grupos: factores extrínsecos (los que actúan sobre el cuerpo) e intrínsecos (los que actúan desde dentro del cuerpo).…”

Section: Introductionunclassified

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Tendinopatías: etiología, histopatología y avances terap

Alvarado¹

2019

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Objetivos: Describir los principales cambios histopatológicos presentes en las tendinopatías, su patogénesis y los avances terapéuticos encontrados en la literatura. Palabras Claves: Tendinopatías, histología, patogénesis, inflamación, tendinosis, regeneración. Materiales y métodos: Se realizó una búsqueda de literatura relacionada con las tendinopatías su patogénesis, cambios histológicos, avances terapéuticos en el uso de células madres, factores de crecimiento (plasma rico en plaquetas) y terapia farmacológica. Se utilizaron las bases de datos de pubmed, clinical key, science direct. Se incluyeron artículos de revisiones bibliográficas entre 2005 al 2018, escritos en inglés. Conclusiones: Las tendinopatías tienen un complejo origen multifactorial, donde los factores extrínsecos e intrínsecos juegan un papel importante para el desarrollo de dicha afectación. La inflamación tiene un rol determinante en el desarrollo de la patogenia de las tendinopatías. La terapia farmacológica antiinflamatoria tiene efectos a corto plazo en la disminución del dolor, sin embargo, resulta contraproducente a largo plazo. Existe controversia sobre el uso del Plasma rico en plaquetas (PRP) y de terapia celular (stem cells), se requiere de mayor investigación que pueda evidenciar la eficacia de dichos tratamientos.

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Section: Cambios Histológicos Del Tendónunclassified

Section: Introductionunclassified

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Tendinopatías: etiología, histopatología y avances terap

Alvarado¹

2019

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“…The organization of tendon structure from collagen fibrils to the entire tendon. Note that collagen fibrils are comprised of polymerized tropocollagen mers …”

Section: Modeling Achilles Tendon Structurementioning

confidence: 99%

A conceptual framework for computational models of Achilles tendon homeostasis

Smith

Rubenson

Lloyd

et al. 2013

WIREs Mechanisms of Disease

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Computational modeling of tendon lags the development of computational models for other tissues. A major bottleneck in the development of realistic computational models for Achilles tendon is the absence of detailed conceptual and theoretical models as to how the tissue actually functions. Without the conceptual models to provide a theoretical framework to guide the development and integration of multiscale computational models, modeling of the Achilles tendon to date has tended to be piecemeal and focused on specific mechanical or biochemical issues. In this paper, we present a new conceptual model of Achilles tendon tissue homeostasis, and discuss this model in terms of existing computational models of tendon. This approach has the benefits of structuring the research on relevant computational modeling to date, while allowing us to identify new computational models requiring development. The critically important functional issue for tendon is that it is continually damaged during use and so has to be repaired. From this follows the centrally important issue of homeostasis of the load carrying collagen fibrils within the collagen fibers of the Achilles tendon. Collagen fibrils may be damaged mechanically-by loading, or damaged biochemically-by proteases. Upon reviewing existing computational models within this conceptual framework of the Achilles tendon structure and function, we demonstrate that a great deal of theoretical and experimental research remains to be done before there are reliably predictive multiscale computational model of Achilles tendon in health and disease.

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“…Functional use of the involved upper extremity, especially during gripping activities usually exacerbates pain symptoms [1,2]. Although LE has been traditionally defined as an inflammatory process, several more recent studies have shown that the pathophysiology of this process is degenerative in nature [3-5]. Regardless of the aetiology, LE represents a pathology that accounts for lost recreation time, decreased quality of life, and work-related disability claims, and LE also has widespread social, financial, and clinical implications [6].…”

Section: Introductionmentioning

confidence: 99%

Quality measures for the care of patients with lateral epicondylalgia

Minaya-Muñoz

Medina-Mirapeix

Valera-Garrido

2013

BMC Musculoskelet Disord

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BackgroundLateral epicondylalgia (LE) defines a condition of varying degrees of pain near the lateral epicondyle. Studies on the management of LE indicated unexplained variations in the use of pharmacologic, non-pharmacological and surgical treatments.The main aim of this paper was to develop and evaluate clinical quality measures (QMs) or quality indicators, which may be used to assess the quality of the processes of examination, education and treatment of patients with LE.MethodsDifferent QMs were developed by a multidisciplinary group of experts in Quality Management of Health Services during a period of one year. The process was based following a 3-step model: i) review and proportion of existing evidence-based recommendations; ii) review and development of quality measures; iii) pilot testing of feasibility and reliability of the indicators leading to a final consensus by the whole panel.ResultsOverall, a set of 12 potential indicators related to medical and physical therapy assessment and treatment were developed to measure the performance of LE care. Different systematic reviews and randomized control trials supported each of the indicators judged to be valid during the expert panel process. Application of the new indicator set was found to be feasible; only the measurement of two quality measures had light barriers. Reliability was mostly excellent (Kappa > 0.8).ConclusionsA set of good practice indicators has been built and pilot tested as feasible and reliable. The chosen 3-step standardized evidence-based process ensures maximum clarity, acceptance and sustainability of the developed indicators.

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Tendinopathies of the Elbow, Wrist, and Hand: Histopathology and Clinical Considerations

Cited by 30 publications

References 69 publications

Tendinopatías: etiología, histopatología y avances terap

Tendinopatías: etiología, histopatología y avances terap

A conceptual framework for computational models of Achilles tendon homeostasis

Quality measures for the care of patients with lateral epicondylalgia

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