Tendinopathy: Investigating the Intersection of Clinical and Animal Research to Identify Progress and Hurdles in the Field

Titan, Ashley L.; Andarawis‐Puri, Nelly

doi:10.2106/jbjs.rvw.15.00088

Cited by 7 publications

(3 citation statements)

References 113 publications

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“…For this type of clinical standardization, the ability to quantify the subjective level of pain is of basic importance [8]. Unfortunately, such an objective method of pain quantization does not exist in clinical use.…”

Section: Prospectivementioning

confidence: 99%

Tendon Injury Following Strenuous Activity: (Acute, Repetitive, and Chronic)

Rosenberg¹

2023

Tendons - Trauma, Inflammation, Degeneration, and Treatment

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Tendon biomechanics are governed by tendon structure. The collagen fibers’ “uncrimping effect,” which transforms their mutually nonparallel orientation to parallel in response to external force, underlies the range of tendon elasticity. The Golgi tendon organs control tendon proprioception. The mechanosensing proprioception may help to some extent protect the mechanical integrity of the tendon; in degenerative tendons, it could be expressed by pain. The tendon’s intrinsic structure may fail when the acute, chronic, or recurrent external load exceeds the tendon’s structural and mechanical resistance. The most significant factor leading to tendon rupture is excessive load, either acute or repetitive. When aging or a chronic illness is present, the magnitude of the excessive load is reduced.

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Section: Prospectivementioning

confidence: 99%

Tendon Injury Following Strenuous Activity: (Acute, Repetitive, and Chronic)

Rosenberg¹

2023

Tendons - Trauma, Inflammation, Degeneration, and Treatment

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“…Furthermore, tendinopathies represent an important socioeconomic problem, involving annual costs above EUR 800 for each patient [ 5 , 6 ]. The most frequently affected tendons are the Achilles, rotator cuff, and patellar tendons [ 7 , 8 , 9 ]. These tendons, due to their anatomical and biomechanical characteristics, are usually subjected to high loads, with various vectors of action [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

A New Quantitative Tool for the Ultrasonographic Assessment of Tendons: A Reliability and Validity Study on the Patellar Tendon

Albarova-Corral,

Segovia-Burillo,

Malo-Urriés

et al. 2024

Diagnostics

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Ultrasound is widely used for tendon assessment due to its safety, affordability, and portability, but its subjective nature poses challenges. This study aimed to develop a new quantitative analysis tool based on artificial intelligence to identify statistical patterns of healthy and pathological tendons. Furthermore, we aimed to validate this new tool by comparing it to experts’ subjective assessments. A pilot database including healthy controls and patients with patellar tendinopathy was constructed, involving 14 participants with asymptomatic (n = 7) and symptomatic (n = 7) patellar tendons. Ultrasonographic images were assessed twice, utilizing both the new quantitative tool and the subjective scoring method applied by an expert across five regions of interest. The database contained 61 variables per image. The robustness of the clinical and quantitative assessments was tested via reliability analyses. Lastly, the prediction accuracy of the quantitative features was tested via cross-validated generalized linear mixed-effects logistic regressions. These analyses showed high reliability for quantitative variables related to “Bone” and “Quality”, with ICCs above 0.75. The ICCs for “Edges” and “Thickness” varied but mostly exceeded 0.75. The results of this study show that certain quantitative variables are capable of predicting an expert’s subjective assessment with generally high cross-validated AUC scores. A new quantitative tool for the ultrasonographic assessment of the tendon was designed. This system is shown to be a reliable and valid method for evaluating the patellar tendon structure.

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“…With regard to the animal model, currently there are two popular techniques to generate tendinopathy: chemical induction of injury or mechanical overloading the model. However, each animal model was limited in reproducing the complex human tendinopathy pathology 13,14 .…”

Section: Introductionmentioning

confidence: 99%

A Protocol to Acquire the Degenerative Tenocyte from Humans

Han

Kim

Ahn

et al. 2018

JoVE

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Tendinopathy, a painful condition that develops in response to tendon degeneration, is on the rise in the developed world due to increasing physical activity and longer life expectancy. Despite its increasing prevalence, the underlying pathogenesis still remains unclear, and treatment is generally symptomatic. Recently, numerous therapeutic options, including growth factors, stem cells, and gene therapy, were investigated in hopes of enhancing the healing potency of the degenerative tendon. However, the majority of these research studies were conducted only on animal models or healthy human tenocytes. Despite some studies using pathological tenocytes, to the best of our knowledge there is currently no protocol describing how to obtain human degenerative tenocytes. The aim of this study is to describe a standard protocol for acquiring human degenerative tenocytes. Initially, the tendon tissue was harvested from a patient with lateral epicondylitis during surgery. Then biopsy samples were taken from the extensor carpi radialis brevis tendon corresponding to structural changes observed at the time of surgery. All of the harvested tendons appeared to be dull, gray, friable, and edematous, which made them visually distinct from the healthy ones. Tenocytes were cultured and used for experiments. Meanwhile, half of the harvested tissues were analyzed histologically, and it was shown that they shared the same key features of tendinopathy (angiofibroblastic dysplasia or hyperplasia). A secondary analysis by immunocytochemistry confirmed that the cultured cells were tenocytes with the majority of the cells having positive stains for mohawk and tenomodulin proteins. The qualities of the degenerative nature of tenocytes were then determined by comparing the cells with the healthy control using a proliferation assay or qRT-PCR. The degenerative tenocyte displayed a higher proliferation rate and similar gene expression patterns of tendinopathy that matched previous reports. Overall, this new protocol might provide a useful tool for future studies of tendinopathy.

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Tendinopathy: Investigating the Intersection of Clinical and Animal Research to Identify Progress and Hurdles in the Field

Cited by 7 publications

References 113 publications

Tendon Injury Following Strenuous Activity: (Acute, Repetitive, and Chronic)

Tendon Injury Following Strenuous Activity: (Acute, Repetitive, and Chronic)

A New Quantitative Tool for the Ultrasonographic Assessment of Tendons: A Reliability and Validity Study on the Patellar Tendon

A Protocol to Acquire the Degenerative Tenocyte from Humans

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