Alterations of tendons in patients with diabetes mellitus: a systematic review

Oliveira, Rodrigo Ribeiro de; Lemos, Alice Fernandes de; Silveira, Patrícia Verçoza de Castro; Silva, R. J. da; Moraes, Sílvia Regina Arruda de

doi:10.1111/j.1464-5491.2010.03197.x

Cited by 52 publications

(46 citation statements)

References 22 publications

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“…All these studies presented abnormal changes of the thickness and structure of collagen fibers in diabetic tendons, although the association between diabetes mellitus and tendon alterations could not be sustained due to methodological drawbacks [11]. However, all the studies reported the increasing trend of thickening tendons in diabetic patients.…”

Section: Imaging Findingsmentioning

confidence: 96%

“…However, not all the patients with DM are symptomatic, some of them are asymptomatic, even with an increased thickness or structural abnormalities in supraspinatus and biceps tendons and Achilles tendons found with imaging exams [11]. It is suggested that the insensitive neuropathy may reduce or even block the transmission of pain signal, thus leading to asymptomatic conditions in some patients with DM [21].…”

Section: Clinical Manifestation Of Tendon Pathologies In Diabetic Patmentioning

confidence: 98%

“…Recently, some studies reported the tendon alternations in patients with diabetes following imaging examinations, such as ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) [11]. In this review, we summarized the current evidence on the alternations of tendons from both clinical patients and animal models of DM.…”

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confidence: 98%

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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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Section: Imaging Findingsmentioning

confidence: 96%

Section: Clinical Manifestation Of Tendon Pathologies In Diabetic Patmentioning

confidence: 98%

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

Shi

Menemenlis

et al. 2015

International Orthopaedics (SICOT)

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“…This study presents, to the best of the authors' knowledge, the first attempt to correlate biomarkers as factors of good prognosis to the evolution of the recovery. Hyperglycemia and especially type II diabetes, leads to a disorganization of collagen fibers, and an increase in tendons thickness and volume [20] ; hyperthyroidism increases collagen catabolism and hypothyroidism leads to a decreased collagen metabolism [21]; hypercholesterolemia impairs the tendon extra cell matrix and thus alters its biomechanical properties [22] and finally, hyperucemia could cause an inflammation provoking the degeneration of the tendon tissue [23]. It might then be surprising that no correlation was found between the values of the biological markers and the evolution of the tendons healing evaluated by the VAS and the algometer.…”

Section: Are There Biologic Factors Of Good Prognosis After a Platelementioning

confidence: 99%

Are There Biologic Factors of Good Prognosis after a Platelet Rich Plasma (PRP) Injection for Tendinopathies ?

Libertiaux

Sancerne²,

Goff

et al. 2016

JESO

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Open Access Short communicationof extrinsinc factors include unadapted material, bad training planification, or usage of some drugs (quinolones, corticoids,…) [4]. Some patients are refractory to the traditional treatments (including physiotherapy, shockwaves, deep transverse massage, etc.) and thus need another option. Less invasive than surgery, Platelet-Rich Plasma (PRP) injection has become more and more popular over the last decades, particularly in sports medicine [5][6][7]. In this paper, in addition of presenting the data asserting the effectiveness of injections of reproducible PRP collected from an apheresis machine on different tendinopathies, we introduce another original contribution : the investigation of the possible correlation between several biomarkers and healing evolution to determine the factors of good prognosis, if any. Material and MethodsForty-eight patients (mean age = 49 y.o +/-10 y.o, min = 26 y.o, max = 77 y.o. ; 15 women and 33 men) afflicted with different pathologies participated in this study after they gave their informed consent (lateral epicondylitis (n=20), medial epicondylitis (n=3), tendinopathy of the gluteus medius (n=1), patellar tendinopathy (n=6), calcaneal tendinopathy (n=14), and plantar fasciitis (n=4)). To be recruited, the patients have had to suffer from a chronic tendinopathy for more than 3 months and be refractory to the following classical treatments : non steroidal anti inflammatory drugs, electrotherapy, deep transverse massage, eccentric revalidation and shockwaves therapy. A clinical examination was carried out to confirm the diagnosis and to exclude any other pathology, including metabolic disease. After this first step, a blood sample was drawn and analyzed to quantify the presence of various metabolic biomarkers (glycemia, thyroid hormons, cholesterolemia, uricemia) which are considered to be risk factors of tendinopathies. The initial pain assessment was made using a Visual Analogic Scale (VAS) of pain and a pressure algometer (Commander Algometer, Tech Medical) prior to the PRP collection. The PRP collection and injection protocol used has already been described in previous AbstractBackground : The aims of this study were to evaluate the effect of a single PRP injection followed by a standardized reeducation protocol among patients suffering from different tendinopathies, but otherwise healthy, and to determine the biomarkers that constitute good prognosis factors, if any.

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“…The mechanism by which diabetes acts on the structure of the collagen of tendons has not been fully understood yet 1,[4][5][6][7] . However, there is evidence that hyperglycemia can cause an accelerated process of nonenzymatic glycation and deposition of collagen in a disorganized form in periarticular connective tissues 6,8,9 .…”

Section: Introductionmentioning

confidence: 99%