Our Summary

This research paper discusses tendon disorders which can affect anyone, regardless of age or activity level. When a tendon gets injured, it goes through three stages of healing: an inflammation stage, a proliferation (or growth) stage, and a remodeling stage. However, even after healing, the tendon doesn’t regain its original strength and flexibility. The paper looks at the various factors involved in this healing process, such as cells, transcription factors (proteins that control the rate of transcription of genetic information), components of the extracellular matrix (a network of non-living tissue that provides support to cells), cytokines and growth factors (substances that are involved in cell signaling), and the formation of new blood vessels. The goal of the research is to understand this process better in order to come up with new treatments to improve recovery from tendon disorders, which are currently difficult to manage medically.

FAQs

  1. What are the three phases of tendon healing after an acute injury?
  2. Why do healed tendons fail to recover their original mechanical properties?
  3. What are the key factors involved in the tendon healing process?

Doctor’s Tip

One helpful tip a doctor might give a patient about tendon repair is to follow a comprehensive rehabilitation program after surgery or injury. This program may include exercises to improve flexibility, strength, and range of motion in the affected area, as well as guidance on proper nutrition and rest to support healing. It is important to follow the guidance of healthcare professionals to ensure the best possible outcome for tendon repair.

Suitable For

Patients who are typically recommended tendon repair are those who have suffered from acute tendon injuries, such as athletes, workers, and elderly individuals. Tendon disorders can affect people of all ages and can lead to decreased mobility and function if not treated properly. The healing process of tendons involves several phases, including inflammation, proliferation, and remodeling, but the healed tendon may not fully regain its original mechanical properties. Understanding the key factors involved in tendon healing, such as cells, transcription factors, extracellular matrix components, cytokines, growth factors, and vascularization, can help in developing new therapeutic approaches to improve patients’ recovery. Tendon disorders management remains a medical challenge, but with advancements in research and treatment options, patients can have better outcomes after tendon repair surgery.

Timeline

Before tendon repair:

  1. Acute injury: The patient experiences sudden pain, swelling, and limited range of motion in the affected tendon.

  2. Diagnosis: The patient undergoes medical evaluation, imaging tests (such as MRI), and possibly a physical examination to determine the extent of the tendon injury.

  3. Pre-operative preparation: The patient may undergo physical therapy, pain management, and other interventions to prepare for surgery.

  4. Tendon repair surgery: The patient undergoes surgical repair of the damaged tendon, which may involve suturing the torn ends together or using a graft.

After tendon repair:

  1. Inflammatory phase: The body initiates an inflammatory response to the surgical trauma, leading to swelling, pain, and redness at the surgical site.

  2. Proliferative phase: Fibroblasts and other cells begin to produce collagen and other extracellular matrix components to rebuild the tendon structure.

  3. Remodeling phase: The newly formed tissue matures and strengthens over time, but may never fully regain its original mechanical properties.

  4. Rehabilitation: The patient undergoes physical therapy and other interventions to regain strength, flexibility, and function in the repaired tendon.

  5. Follow-up care: The patient may require regular follow-up appointments with their healthcare provider to monitor the healing process and address any complications that may arise.

What to Ask Your Doctor

  1. What is the extent of my tendon injury and what is the recommended treatment plan for tendon repair?
  2. What are the potential risks and complications associated with tendon repair surgery?
  3. How long is the expected recovery time and rehabilitation process following tendon repair surgery?
  4. Will physical therapy be necessary after tendon repair surgery, and if so, for how long?
  5. What are the expected outcomes and success rates of tendon repair surgery for my specific injury?
  6. Are there any alternative treatment options to tendon repair surgery that I should consider?
  7. How can I prevent future tendon injuries or re-injury after undergoing tendon repair surgery?
  8. Are there any specific lifestyle changes or modifications that I should make to aid in the healing process of my tendon injury?
  9. Will I need any imaging tests or follow-up appointments to monitor the healing progress of my tendon after surgery?
  10. Are there any specific exercises or activities that I should avoid during the recovery period following tendon repair surgery?

Reference

Authors: Darrieutort-Laffite C, Blanchard F, Soslowsky LJ, Le Goff B. Journal: Joint Bone Spine. 2024 Sep;91(5):105696. doi: 10.1016/j.jbspin.2024.105696. Epub 2024 Feb 1. PMID: 38307405