Tendinopathy: A Review of the Pathophysiology and Evidence for Treatment

Goldin, Mark M.; Malanga, Gerard A.

doi:10.3810/psm.2013.09.2019

Cited by 16 publications

(12 citation statements)

References 52 publications

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“…The development of tendinopathy is attributed to progressive pathological changes in tendons that consequently compromise tendon structure and function. 59 Results from a recent study suggests that in tendinopathy, exogenous inflammatory cytokines are released from immigrated leukocytes, which trigger tenocytes to produce pro-inflammatory mediators, and proteases such as MMPs. 60 One of the characteristics of senescent cells is an excessive increase in the levels of MMPs, ADAMTS, and pro-inflammatory cytokines such as TNF-α and IL-1β.…”

Section: Cellular Senescence and Its Biological Impact On Tendon mentioning

confidence: 99%

Biology and mechano‐response of tendon cells: Progress overview and perspectives

Sun

Schaniel

Leong

et al. 2015

Journal Orthopaedic Research

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In this review, we summarize the group discussions on Cell Biology & Mechanics from the 2014 ORS/ISMMS New Frontiers in Tendon Research Conference. The major discussion topics included: 1) the biology of tendon stem/progenitor cells (TSPCs) and the potential of stem cell-based tendon therapy using TSPCs and other types of stem cells, namely, embryonic and/or induced pluripotent stem cells (iPSCs), 2) the biological concept and potential impact of cellular senescence on tendon aging, tendon injury repair and the development of degenerative disease, and 3) the effects of tendon cells’ mechano-response on tendon cell fate and metabolism. For each topic, a brief overview is presented which summarizes the major points discussed by the group participants. The focus of the discussions ranged from current research progress, challenges and opportunities, to future directions on these topics. In the preparation of this manuscript, authors consulted relevant references as a part of their efforts to present an accurate view on the topics discussed.

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Section: Cellular Senescence and Its Biological Impact On Tendon mentioning

confidence: 99%

Biology and mechano‐response of tendon cells: Progress overview and perspectives

Sun

Schaniel

Leong

et al. 2015

Journal Orthopaedic Research

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“…It comprises various treatment options. A systematic review of the literature suggests eccentric muscle strengthening exercises are a good form of physical therapy while physical therapy modalities such as iontophoresis, ultrasound, phonophoresis, and low-level laser treatment lack sufficient evidence at this time [13]. Musculotendinous strengthening appears to be essential in tendon rehabilitation.…”

Section: Introductionmentioning

confidence: 99%

Dry Needling as a Treatment Modality for Tendinopathy: a Narrative Review

Stoychev

Finestone

Kalichman

2020

Curr Rev Musculoskelet Med

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Purpose of Review Tendinopathy describes a combination of pain, swelling, and impaired performance of the tendon and around structures. There are various treatment options for tendinopathy with unclear efficacy. Dry needling involves inserting needles into the affected tendon, and it is thought to disrupt the chronic degenerative process and encourage localized bleeding and fibroblastic proliferation. The purpose of this review is to review the use of dry needling as a treatment modality for tendinopathy. Recent Findings The effectiveness of dry needling for treatment of tendinopathy has been evaluated in 3 systematic reviews, 7 randomized controlled trials, and 6 cohort studies. The following sites were studied: wrist common extensor origin, patellar tendon, rotator cuff, and tendons around the greater trochanter. There is considerable heterogeneity of the needling techniques, and the studies were inconsistent about the therapy used after the procedure. Most systematic reviews and randomized controlled trials support the effectiveness of tendon needling. There was a statistically significant improvement in the patient-reported symptoms in most studies. Some studies reported an objective improvement assessed by ultrasound. Two studies reported complications. Summary Current research provides initial support for the efficacy of dry needling for tendinopathy treatment. It seems that tendon needling is minimally invasive, safe, and inexpensive, carries a low risk, and represents a promising area of future research. In further high-quality studies, tendon dry needling should be used as an active intervention and compared with appropriate sham interventions. Studies that compare the different protocols of tendon dry needling are also needed.

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“…The inability to regain normal tissue structure and mechanical properties often leads to tissue degeneration and chronic reinjury. Despite the frequency at which these injuries occur, and the associated loss of function and productivity they engender, there are few effective treatments available [ 4 ]. Tendinopathies are particularly difficult to treat due to their chronic and degenerative nature, which no current treatments are able to adequately resolve.…”

Section: Introductionmentioning

confidence: 99%

Novel roles for scleraxis in regulating adult tenocyte function

et al. 2018

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BackgroundTendinopathies are common and difficult to resolve due to the formation of scar tissue that reduces the mechanical integrity of the tissue, leading to frequent reinjury. Tenocytes respond to both excessive loading and unloading by producing pro-inflammatory mediators, suggesting that these cells are actively involved in the development of tendon degeneration. The transcription factor scleraxis (Scx) is required for the development of force-transmitting tendon during development and for mechanically stimulated tenogenesis of stem cells, but its function in adult tenocytes is less well-defined. The aim of this study was to further define the role of Scx in mediating the adult tenocyte mechanoresponse.ResultsEquine tenocytes exposed to siRNA targeting Scx or a control siRNA were maintained under cyclic mechanical strain before being submitted for RNA-seq analysis. Focal adhesions and extracellular matrix-receptor interaction were among the top gene networks downregulated in Scx knockdown tenocytes. Correspondingly, tenocytes exposed to Scx siRNA were significantly softer, with longer vinculin-containing focal adhesions, and an impaired ability to migrate on soft surfaces. Other pathways affected by Scx knockdown included increased oxidative phosphorylation and diseases caused by endoplasmic reticular stress, pointing to a larger role for Scx in maintaining tenocyte homeostasis.ConclusionsOur study identifies several novel roles for Scx in adult tenocytes, which suggest that Scx facilitates mechanosensing by regulating the expression of several mechanosensitive focal adhesion proteins. Furthermore, we identified a number of other pathways and targets affected by Scx knockdown that have the potential to elucidate the role that tenocytes may play in the development of degenerative tendinopathy.Electronic supplementary materialThe online version of this article (10.1186/s12860-018-0166-z) contains supplementary material, which is available to authorized users.

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Tendinopathy: A Review of the Pathophysiology and Evidence for Treatment

Cited by 16 publications

References 52 publications

Biology and mechano‐response of tendon cells: Progress overview and perspectives

Biology and mechano‐response of tendon cells: Progress overview and perspectives

Dry Needling as a Treatment Modality for Tendinopathy: a Narrative Review

Novel roles for scleraxis in regulating adult tenocyte function

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