Our Summary

Tendons and ligaments are important parts of our body, but if they get injured, they have a hard time healing, even with proper treatment. This is because they are made up of different materials and have different structures that adapt according to the different pressures or loads they face. These loads can be tension (pulling), compression (pushing), and shear (sliding).

These different loads activate various molecular pathways in our body that help in the repair and growth of tissues. Some of these pathways are regulated by genes that help in tendon development and growth. In this paper, the authors discuss how these pathways are regulated during different stages of tendon and ligament development.

However, when tendons or ligaments are injured or diseased, the loads on them change. This could disrupt the normal functioning of these molecular pathways, leading to incomplete healing or even degeneration of the tissue.

The authors suggest that by understanding these processes better, we could develop more effective treatments and rehabilitation methods, and even engineer new tendons or ligaments. The findings in this paper are based on a range of studies, including laboratory experiments, animal studies, and human trials.

FAQs

  1. What factors complicate the restoration of native tissue function in tendon and ligament injuries?
  2. How do different musculoskeletal loads regulate tissue remodeling in tendons and ligaments?
  3. What are some structural features of healing and diseased tendon that may contribute to aberrant loading profiles and how might they affect healing?

Doctor’s Tip

A doctor may advise a patient undergoing tendon repair to follow a structured rehabilitation program that includes specific exercises to gradually strengthen the repaired tendon. It is important to follow the guidance of a physical therapist or healthcare provider to ensure proper healing and prevent re-injury. Additionally, maintaining a healthy lifestyle with regular exercise, proper nutrition, and adequate rest can support the healing process and overall tendon health.

Suitable For

Patients who may be recommended tendon repair include those with acute or chronic tendon injuries, such as tendonitis or tendon tears. These injuries may occur as a result of overuse, trauma, or age-related degeneration. Patients who have not responded to conservative treatments such as rest, physical therapy, and anti-inflammatory medications may be candidates for surgical tendon repair. Additionally, athletes or individuals with high physical demands on their tendons may require surgical intervention to restore function and prevent further damage.

Timeline

Before tendon repair:

  1. Injury: The patient sustains a tendon injury, which can be caused by trauma, overuse, or degenerative conditions.
  2. Evaluation: The patient seeks medical evaluation to assess the extent of the tendon injury and determine the need for surgical intervention.
  3. Pre-operative care: The patient may undergo physical therapy, immobilization, or other conservative treatments to prepare for surgery.
  4. Surgical repair: The patient undergoes tendon repair surgery, which may involve various techniques such as suturing, grafting, or augmentation.
  5. Post-operative care: The patient follows a rehabilitation program to regain strength and function in the repaired tendon, which may include physical therapy, splinting, and activity modification.

After tendon repair:

  1. Immediate post-operative period: The patient experiences pain, swelling, and limited range of motion in the repaired tendon, which gradually improves with proper wound care and pain management.
  2. Early rehabilitation: The patient begins a structured rehabilitation program to promote healing and prevent complications such as stiffness or weakness in the repaired tendon.
  3. Intermediate rehabilitation: The patient progresses to more advanced exercises and activities to gradually increase strength, flexibility, and function in the repaired tendon.
  4. Late rehabilitation: The patient continues to participate in rehabilitation to optimize long-term outcomes and prevent re-injury, with a focus on functional activities and return to sports or daily activities.
  5. Long-term follow-up: The patient may require ongoing monitoring and occasional follow-up appointments with their healthcare provider to ensure the repaired tendon remains strong and healthy.

What to Ask Your Doctor

  1. What is the extent of my tendon injury and what are the treatment options available for tendon repair?
  2. What are the potential risks and complications associated with tendon repair surgery?
  3. What is the expected recovery time and rehabilitation process following tendon repair surgery?
  4. Are there any alternative non-surgical treatment options for tendon repair that I should consider?
  5. What type of physical therapy or exercise regimen will be necessary for optimal healing and strengthening of the repaired tendon?
  6. How can I prevent future tendon injuries or re-injury after the repair surgery?
  7. Are there any specific lifestyle changes or modifications I should make to support the healing process of the repaired tendon?
  8. What are the long-term outcomes and expectations for the functionality of the repaired tendon?
  9. Are there any specific dietary or nutritional recommendations that can support tendon healing and repair?
  10. Are there any specific risk factors or underlying conditions that may affect the success of the tendon repair surgery that I should be aware of?

Reference

Authors: Tam KT, Baar K. Journal: Matrix Biol. 2025 Feb;135:39-54. doi: 10.1016/j.matbio.2024.12.001. Epub 2024 Dec 5. PMID: 39645093