Neovascularisation in chronic painful patellar tendinosis?promising results after sclerosing neovessels outside the tendon challenge the need for surgery
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Tendinosis
Tendon is important structure of the human body, since it can sustain tensile loading. The primary function of this tissue is to stabilize the joints they attached to it during daily activities. As well as, tendon has viscoelastic properties that can determine their response to loading and restrict the potential of injuries. One of the major points that this paper works with is the study of the biomechanical behaviour of tendon in response to tensile loading to describe their biological behaviour. Also, conclude the mathematical expression that may illustrate the tendon behaviour. All of the experiments were made in Physiology laboratories / Medical College/ Al- Nahrain University on ten rats "Rattus Norvegicus" of [108- 360] gm weight for in- vitro tensile test. So that 20 specimens were dissected from the rat knees, for the patellar tendons which always hydrated to prevent the tissue dryness. The results of the study, shows the behaviour of the tendon in response to tensile loading with two techniques; the dead loads technique and the continuous loads technique. The stress- strain relationships were also evaluated, as well as, the modified superposition theory was applied at different strain levels to the patellar tendon. The obtained results show that the modified superposition theory gives good results that are partly similar to the experimental results. Also, the tendon shows longer initial pattern than that for the ligament due to the presence of higher elastin content in the tendon than in the ligament.
Biomechanics
Collagen fibres
Strain (injury)
Patellar ligament
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Patellar ligament
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Tendinosis
Polidocanol
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Summary Tendon and muscle lesions appear in manifold forms clinically as well as on magnetic resonance or ultrasound images. Tendinous abnormalities may be classified and staged with respect to their biomechanical role in a kinetic chain by using the concept of the tendon overuse syndrome (TOS). In the first phase, painful functional impairment of movements occurs without any morphological changes. In the second stage, abnormalities of the gliding tissue in the form of bursitis, tendovaginitis or peritendinitis are observed. In the third stage, such lesions are followed by degenerative changes of the tendon itself. Often, they present more clearly than during the early forms of TOS and three types of tendon degeneration can be differentiated: tendinosis at distinct points along the course of the tendon, fibroostosis at the tendon insertion and compression or impingement syndromes. Rupture of fibres following tendinosis may be considered as the last or fourth stage of TOS.
Tendinosis
Bursitis
Degeneration (medical)
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Tendinosis
Tendinitis
Degeneration (medical)
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Tendon injuries range from acute traumatic ruptures and lacerations to chronic overuse injuries, such as tendinosis. Even with improved nonsurgical, surgical, and rehabilitation techniques, outcomes following tendon repair are inconsistent. Primary repair remains the standard of care. However, repaired tendon tissue rarely achieves functionality equal to that of the preinjured state. Poor results have been linked to alterations in cellular organization within the tendon that occur at the time of injury and throughout the early stages of healing. Enhanced understanding of the biology of tendon healing is needed to improve management and outcomes. The use of growth factors and mesenchymal stem cells and the development of biocompatible scaffolds could result in enhanced tendon healing and regeneration. Recent advances in tendon bioengineering may lead to improved management following tendon injury.
Tendinosis
Biocompatible material
Scar tissue
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Rabbit (cipher)
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Tendon disorders are frequent, and are responsible for much morbidity both in sport and the workplace. Although the presence of degenerative changes does not always lead to symptoms, pre-existing degeneration has been implicated as a risk factor for acute tendon rupture. The term tendinopathy is a generic descriptor of the clinical conditions in and around tendons arising from overuse. The terms "tendinosis" and "tendinitis/tendonitis" should only be used after histopathological examination. Disordered healing is seen in tendinopathy, and inflammation is not typically seen. In acute injuries, the process of tendon healing is an indivisible process that can be categorized into three overlapping phases for descriptive purposes. Tendon healing can occur intrinsically, via proliferation of epitenon and endotenon tenocytes, or extrinsically, by invasion of cells from the surrounding sheath and synovium. Despite remodeling, the biochemical and mechanical properties of healed tendon tissue never match those of intact tendon. Tendon injuries account for considerable morbidity, and often prove disabling for several months, despite what is considered appropriate management. Chronic problems caused by overuse of tendons probably account for 30% of all running-related injuries, and the prevalence of elbow tendinopathy in tennis players can be as high as 40%. The basic cell biology of tendons is still not fully understood, and the management of tendon injury poses a considerable challenge for clinicians. This article describes the structure of tendons, and reviews the pathophysiology of tendon injury and healing.
Tendinosis
Tendinitis
Tendonitis
Tennis elbow
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Patellar ligament
Biomechanics
Aponeurosis
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