The midterm effects of diabetes mellitus on quadriceps and patellar tendons in patients with knee arthrosis: a comparative radiological study

Altınel, Levent; Köse, Kamil Çağrı; Değirmenci, Bumin; Petik, Bülent; Acartürk, Gürsel; Çölbay, Mehmet

doi:10.1016/j.jdiacomp.2006.07.003

Cited by 23 publications

(20 citation statements)

References 14 publications

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“…Three examined tendons using ultrasound (US)14 38 40 and two used X-ray 23 26. Despite differences in imaging modality and in diagnostic criteria for tendinopathy (table 1) there was minimal heterogeneity (I 2 =0%) and consistent, significant findings of greater prevalence of tendinopathy in people with diabetes than controls (OR 3·84, 95% CI 3·11 to 4·75).…”

Section: Resultsmentioning

confidence: 99%

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Is there an association between tendinopathy and diabetes mellitus? A systematic review with meta-analysis

et al. 2015

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Section: Resultsmentioning

confidence: 99%

“…Individually, only six of nine studies showed significant results. Studies used various means to acquire images—seven used US,13 14 29 30 37 39 40 one used CT35 and one used MRI 31. Of the seven US studies one had non-significant findings,40 whereas the CT and MRI studies had non-significant findings.…”

Section: Resultsmentioning

confidence: 99%

Is there an association between tendinopathy and diabetes mellitus? A systematic review with meta-analysis

et al. 2015

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“…Besides, they also found more sonographic appearances of degenerative features in the rotator cuff and biceps in DM subjects. Another study also discovered that the quadriceps tendons had more buckling in diabetic patients with MRI examination [25].…”

Section: Imaging Findingsmentioning

confidence: 95%

Alterations of tendons in diabetes mellitus: what are the current findings?

Shi

Menemenlis

et al. 2015

International Orthopaedics (SICOT)

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As a connective tissue, tendon connects the muscle and bone, and plays the key role in the locomotor system. Some previous studies have shown the pathological alternations in diabetic tendons, which might result in the structural and functional changes, and even accelerate the process of diabetic foot. In this review, we examined the current findings of the diabetic tendons in the form of various aspects, and summarized the clinical presentation, imaging, biomechanical, histopathological, cellular and molecular abnormalities in the diabetic tendons. The progress of diabetic tendon damage is complicated and the main hypotheses include the excessive accumulation of AGEs, the altered inflammatory response, neovascularization and insensitive neuropathy. However, the cellular and molecular mechanisms of these alterations are still ambiguous. Tendon stem/progenitor cells (TSPCs) have been discovered to play important roles in both tendon physiology and tendon pathology. Recently, we identified TSPCs from patellar tendons in our well-established diabetic rat model and found impaired tenogenic differentiation potential of these cells. We proposed a new hypothesis that the impaired cell functions of diabetic TSPCs might be the underlying cellular and molecular mechanism of the diabetic tendon alternations. These findings should be helpful to establish a better therapeutic strategy for diabetic tendon repair and regeneration.

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“…1,4–8,10,17,41,43,46,47,49,52,57 Commonly recognized musculoskeletal sequelae of diabetes include Dupuytren’s contracture, carpal tunnel syndrome, flexor tenosynovitis, and adhesive capsulitis. 1,4–8,10,17,41,43,46,47,49,52,57 It is believed that these complications result from alterations in the quantity and function of the structural macromolecules of the extracellular matrix in connective tissues. 3,11–15,31,44,53,55 Both clinical and basic science studies have also revealed that the diabetic phenotype is associated with impaired fracture healing, 9,21,25,26,28,33,34,40,42,60,61 reduced bone mass and bone mineral density, 23,30,32,54 decreased collagen content and defects in cross-linking, 28,31,34,53,59,64 a propensity for shoulder stiffness, 5–7,10,17,43,46–48 as well as a significantly greater risk of infection and complications following open rotator cuff repair.…”

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Diabetes mellitus impairs tendon-bone healing after rotator cuff repair

Bedi

Fox

Harris

et al. 2010

Journal of Shoulder and Elbow Surgery

168

128

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Introduction Studies have demonstrated a significant decrease in skeletal mass, bone mineral density, and impaired fracture healing in the diabetic population. However, the effect of sustained hyperglycemia on tendon-to-bone healing is unknown. Materials and methods Forty-eight male, Lewis rats underwent unilateral detachment of the supraspinatus tendon followed by immediate anatomic repair with transosseous fixation. In the experimental group (n = 24), diabetes was induced preoperatively via intraperitoneal injection of streptozotocin (STZ, 65 mg/kg) and confirmed with both pre- and post-STZ injection intraperitoneal glucose tolerance tests (IPGTT). Animals were sacrificed at 1 and 2 weeks post-operatively for biomechanical, histomorphometric, and immunohistochemical analysis. Serum hemoglobin A1c (HbA1c) levels were measured at 2 weeks postoperatively. Statistical comparisons were performed using Student t tests with significance set at P < .05. Results IPGTT analysis demonstrated a significant impairment of glycemic control in the diabetic compared to control animals (P < .05). Mean HbA1c level at 2 weeks postoperatively was 10.6 ± 2.7% and 6.0 ± 1.0% for the diabetic and control groups, respectively (P < .05). Diabetic animals demonstrated significantly less fibrocartilage and organized collagen, and increased AGE deposition at the tendon-bone interface (P < .05). The healing enthesis of diabetic animals demonstrated a significantly reduced ultimate load-to-failure (4.79 ± 1.33N vs 1.60 ± 1.67N and 13.63 ± 2.33N vs 6.0 ± 3.24N for control versus diabetic animals at 1 and 2 weeks, respectively) and stiffness compared to control animals (P < .05). Discussion Sustained hyperglycemia impairs tendon-bone healing after rotator cuff repair in this rodent model. These findings have significant clinical implications for the expected outcomes of soft tissue repair or reconstructive procedures in diabetic patients with poor glycemic control. Level of Evidence Basic Science Study.

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The midterm effects of diabetes mellitus on quadriceps and patellar tendons in patients with knee arthrosis: a comparative radiological study

Cited by 23 publications

References 14 publications

Is there an association between tendinopathy and diabetes mellitus? A systematic review with meta-analysis

Is there an association between tendinopathy and diabetes mellitus? A systematic review with meta-analysis

Alterations of tendons in diabetes mellitus: what are the current findings?

Diabetes mellitus impairs tendon-bone healing after rotator cuff repair

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