Our Summary

This research paper examines how different types of tendons in the body heal after injury. Tendons that are well supplied with blood (extrasynovial tendons) generally heal well after being cut and repaired. However, tendons that lack a blood supply (intrasynovial tendons) do not heal as effectively.

The researchers studied flexor tendons, which have regions that are both extrasynovial and intrasynovial. They cut and repaired these tendons in different areas and observed the healing process. They also studied the gene expression and proteins involved in healing at 3 and 7 days after the procedure.

They found that uninjured intrasynovial tendons lacked blood vessels and contained high levels of certain proteins. They also found that these tendons expressed inflammatory factors and enzymes involved in energy production. On the other hand, extrasynovial tendons were well supplied with blood, contained low levels of certain proteins, and contained factors that inhibit inflammation.

When injured, the extrasynovial tendons showed a strong and quick response involving the formation of new blood vessels, while the intrasynovial tendons showed only a minimal response. The extrasynovial tendons also showed an increase in certain proteins and a shift in energy production.

The researchers concluded that these differences in healing are due to the different environments in which these tendons are found. They suggest that future treatments should aim to promote the healing features seen in extrasynovial tendons, such as the formation of new blood vessels and changes in energy production.

FAQs

  1. What are the differences in healing between extrasynovial and intrasynovial tendons?
  2. How do the levels of proteins differ between uninjured intrasynovial and extrasynovial tendons?
  3. What treatments do the researchers suggest based on the different healing features of extrasynovial tendons?

Doctor’s Tip

Based on this research, a doctor may advise a patient undergoing tendon repair to follow a rehabilitation plan that promotes blood flow to the injured area, such as gentle exercises and stretching. They may also recommend a diet rich in nutrients that support tendon healing, such as protein and antioxidants. Additionally, the doctor may suggest avoiding activities that put excessive strain on the tendon during the healing process to optimize the chances of a successful repair.

Suitable For

Patients who have experienced injuries to tendons that are well supplied with blood (extrasynovial tendons) are typically recommended for tendon repair. These types of tendons, such as flexor tendons, have a better chance of healing effectively after being cut and repaired. On the other hand, tendons that lack a blood supply (intrasynovial tendons) do not heal as well and may require more intensive treatment.

In cases where tendon repair is recommended, patients may include those who have experienced tendon injuries due to trauma, overuse, or degenerative conditions. Common examples of tendon injuries that may require repair include Achilles tendon ruptures, rotator cuff tears, and tennis elbow.

Overall, the decision to recommend tendon repair will depend on the specific type and location of the tendon injury, as well as the overall health and activity level of the patient. It is important for patients to consult with a healthcare provider to determine the best course of treatment for their individual situation.

Timeline

Before tendon repair:

  1. Patient experiences pain, swelling, and limited range of motion in the affected tendon.
  2. Patient consults with a healthcare provider who diagnoses the tendon injury and recommends tendon repair surgery.
  3. Patient undergoes pre-operative evaluations and tests to ensure they are a suitable candidate for surgery.
  4. Patient schedules the tendon repair surgery and prepares for the procedure.

After tendon repair:

  1. Patient undergoes tendon repair surgery, where the damaged tendon is cut and then surgically reattached.
  2. Patient is placed in a splint or cast to immobilize the repaired tendon and allow it to heal.
  3. Patient begins physical therapy to regain strength and flexibility in the repaired tendon.
  4. Patient gradually increases movement and activity in the affected tendon as it heals.
  5. Patient continues physical therapy and follow-up appointments with their healthcare provider to monitor the healing process and make any necessary adjustments to the treatment plan.

What to Ask Your Doctor

  1. What type of tendon injury do I have (extrasynovial or intrasynovial)?

  2. What is the expected outcome of tendon repair for my specific injury?

  3. What factors can affect the healing process of my tendon injury?

  4. What are the potential risks and complications associated with tendon repair surgery?

  5. How long is the recovery period after tendon repair surgery?

  6. What kind of post-operative rehabilitation and physical therapy will I need?

  7. Are there any specific lifestyle changes or precautions I should take to support the healing of my tendon injury?

  8. Will I need any additional treatments or interventions to support the healing of my tendon injury?

  9. What can I do to prevent re-injury of my tendon after it has been repaired?

  10. Are there any alternative treatment options or approaches that I should consider for my tendon injury?

Reference

Authors: Shen H, Yoneda S, Sakiyama-Elbert SE, Zhang Q, Thomopoulos S, Gelberman RH. Journal: J Bone Joint Surg Am. 2021 May 5;103(9):e36. doi: 10.2106/JBJS.20.01253. PMID: 33475308