The Bonar score revisited: Region of evaluation significantly influences the standardized assessment of tendon degeneration

Objectives Tendinopathy is a common, costly condition affecting both sporting and sedentary populations. Research into tendinopathy frequently involves the evaluation of tendinosis, a pathology characterized by a lack of inflammatory cells, collagen disruption, neovascularisation, altered cell numbers and morphology and increased glycosaminoglycans. Evaluation of these characteristics can be undertaken using the Bonar histopathology score, but the characteristics are heterogeneous throughout tendon specimens with no standardized method of determining the area to be evaluated. The objective of this study was to assess whether the Bonar score varies depending on the criteria used to define the area of evaluation.