How can one platelet injection after tendon injury lead to a stronger tendon after 4 weeks?: Interplay between early regeneration and mechanical stimulation

Virchenko, Olena; Aspenberg, Per

doi:10.1080/17453670610013033

Cited by 222 publications

(179 citation statements)

References 17 publications

(15 reference statements)

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“…Healing of the rat Achilles tendon is sensitive to mechanical loading. The strength of the tendon callus is reduced by 3 = 4 after 14 days if loading is prevented by Botox injections in the manner of our study [16]. Also the response to exogenous GDFs is influenced by loading: if loading is prevented, exogenous GDFs lead to more cartilage and bone formation [6].…”

Section: Discussionmentioning

confidence: 60%

“…Follistatin is expressed around forming chick tendons, and it seems reasonable to presume it serves to delimit their formation. With mechanical loading in our model, the tendon regenerates double their transverse area [16], suggesting delimitation is decreased in parallel with the decrease in follistatin. Follistatin downregulates GDF-6 in Xenopus, but we have found no data in the literature on binding to GDF-5, -6, and -7.…”

Section: Discussionmentioning

confidence: 82%

“…The early tendon callus is really a granuloma consisting of many different cell types, of which only a small part might be fibroblasts or able to respond to mechanical stimulation. We have previously reported very early callus is not stimulated to better mechanical healing by loading [16]. At 14 days, most cells appear fibroblastic, and even more so on day 21.…”

Section: Discussionmentioning

confidence: 85%

“…Mechanical stimulation is crucial for tendon healing [16]. Moreover, mechanical stimulation can direct the response to injected GDFs in a tendon healing model, so that its bone inductive capacity is inhibited in favor of formation of a tendon-like tissue [6].…”

Section: Introductionmentioning

confidence: 99%

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Mechanical Load and BMP Signaling During Tendon Repair: A Role for Follistatin?

Eliasson

Fahlgren

Aspenberg

2008

Clinical Orthopaedics &Amp; Related Research

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Healing of the rat Achilles tendon is sensitive to mechanical loading, and the callus strength is reduced by 3 = 4 after 14 days, if loading is prevented. Exogenous GDFs stimulate tendon healing. This response is influenced by loading: without loading, cartilage and bone formation is initiated. This implies BMP signaling is crucial during tendon healing and influenced by mechanical loading. We therefore asked if mechanical loading influences the gene expression of the BMP signaling system in intact and healing tendons, and how the BMP signaling system changes during healing. The genes were four BMPs (OP-1/BMP-7, GDF-5/CDMP-1/BMP-14, GDF-6/CDMP-2/BMP-13, and GDF-7/CDMP-3/BMP-12), two receptors (BMPR1b and BMPR2), and the antagonists follistatin and noggin. The Achilles tendon was transected in rats and left to heal. Half of the rats had one Achilles tendon unloaded by injection of Botox in the calf muscles. Ten tendons were analyzed before transection and for each of four time points. All genes except noggin were expressed at all time points, but followed different patterns during healing. Loading strongly decreased the expression of follistatin, which could lead to increased signaling. The BMP system appears involved in tendon maintenance and healing, and may respond to mechanical loading.

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Section: Discussionmentioning

confidence: 60%

Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 85%

Section: Introductionmentioning

confidence: 99%

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Mechanical Load and BMP Signaling During Tendon Repair: A Role for Follistatin?

Eliasson

Fahlgren

Aspenberg

2008

Clinical Orthopaedics &Amp; Related Research

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“…Mechanical stimulation is important for healing [13,15,25]. Botox can be used to reduce loading, and acts specifically on the neuromuscular junction.…”

Section: Discussionmentioning

confidence: 99%

Growth Hormone Does Not Stimulate Early Healing in Rat Tendons

2012

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Growth Hormone stimulates bone growth and fracture repair. It acts mainly by increasing the systemic levels of IGF-1. Local treatment with IGF-1 appears to stimulate tendon healing.We therefore hypothesized that systemic treatment with Growth Hormone would also stimulate tendon healing. Rat Achilles tendons were transected and left to heal. Four groups were studied. Intramuscular injections of botulinum toxin A (Botox) were used to reduce loading in 2 groups. The animals were randomized to twice daily injections of Growth Hormone (n = 2 x 10) or saline (n = 2 x 10), and killed after 10 days. Healing was assessed by mechanical testing. Muscle paralysis induced by Botox reduced the strength of the healing tendon by two thirds. Growth Hormone increased femoral and tibial length in the unloaded, and femoral and tibial weight in the loaded group. Body weight and muscle weight were increased in both. In contrast, there was no increase in the strength of the healing tendons, regardless of mechanical loading status. An increase in peak force of the loaded healing tendons by more than 5 % could be excluded with 95 % confidence. In spite of its stimulatory effects on other tissues, Growth Hormone did not appear to stimulate tendon or tendon repair.

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Platelet-Rich Plasma Injection for Chronic Achilles Tendinopathy

Vos

Weir

Schie³

et al. 2010

JAMA

750

629

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VERUSE INJURY OF THE ACHILlestendonisafrequentproblem that often affects sport participantsbutalsoinactive middle-aged individuals. 1,2 An estimated 30% to 50% of all sports-related injuries are tendon disorders. 3 Former distance runners have a lifetime risk of 52% for Achilles tendon injury. 4 Achilles tendon injuries frequently lead to sport cessation for long periods and may interfere with activities of daily living. 5 Conservative treatmentisdisappointingand25%to45% of patients eventually require surgery. 1,5 There is a clear need for improved conservative therapy. Many factors in the etiology and pathogenesis have been reported, but no study has identified a direct causeeffect relationship. 1,2 Previously, the nomenclature tendinitis was generally used for chronic tendon disorders, suggesting the presence of inflammation. 1,2 Histological studies, however, proved abnormal tissue repair and degeneration, which favored the term tendinopathy for the clinical triad of pain, swelling, and decreased activity. 1,2 Anti-inflammatory agents, previously used for chronic tendinopathies without appropriate efficacy, 1,6 have now been replaced by eccentric exercises as usual care 6 that provide some positive effects on tendon collagen synthesis and may result in a decrease of pain. 1,7 The recent introduction of plateletrich plasma (PRP) injections in tendinopathy raised high expectations. 8-11 See also Patient Page.

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How can one platelet injection after tendon injury lead to a stronger tendon after 4 weeks?: Interplay between early regeneration and mechanical stimulation

Cited by 222 publications

References 17 publications

Mechanical Load and BMP Signaling During Tendon Repair: A Role for Follistatin?

Mechanical Load and BMP Signaling During Tendon Repair: A Role for Follistatin?

Growth Hormone Does Not Stimulate Early Healing in Rat Tendons

Platelet-Rich Plasma Injection for Chronic Achilles Tendinopathy

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