Abstract
The biggest compartment of the musculoskeletal system is the tendons and ligaments. In particular, tendons are dense tissues connecting muscle to bone that are critical for the integrity, function and locomotion of this system. Due to the increasing age of our society and the overall rise in engagement in extreme and overuse sports, there is a growing prevalence of tendinopathies. Despite the recent advances in tendon research and due to difficult early diagnosis, a multitude of risk factors and vague understanding of the underlying biological mechanisms involved in the progression of tendon injuries, the toolbox of treatment strategies remains limited and non-satisfactory. This review is designed to summarize the current knowledge of triggers, trails and end state of tendinopathies.
Highlights
Tendon disorders have become very common in today’s athletic and non-athletic population and account for a substantial proportion of activity-related diseases of the musculoskeletal system
We aimed to summarize the current state of knowledge on tendinopathies including potential triggers, trails, end-state and treatment options
Tendons are highly structured dense connective tissues which provide stabilization of joints and are able to store and release elastic energy that allows movement [8,9]. They are mainly composed of collagen fibers and tendon-resident cells which lie embedded in parallel rows (Figure 1a, Figure 2a) in a well-organized extracellular matrix (ECM), containing high amounts of proteoglycans
Summary
Tendon disorders have become very common in today’s athletic and non-athletic population and account for a substantial proportion of activity-related diseases of the musculoskeletal system. The blanket term “tendinopathy” is used to describe a broad spectrum of non-rupture clinical burdens affecting tendons of primary, acute and chronically degenerative tendon pathologies, which are associated with prolonged pain, impaired performance, swelling and further pathological characteristics [1]. “Tendinosis” describes preferentially chronic degenerative conditions of the mid-substance tendon resulting from an accumulation of micro-trauma over time, devoid of inflammatory impact and form the most pathological disorders affecting tendons [1,3]. “Tenosynovitis” ( “paratendinitis” and “peritendinitis”) describes the involvement of the paratenon (paratendinopathy) alone or in combination with tendinosis This term refers to inflammation of the tendinous sheath and is strictly speaking not a classical tendinopathy in which degeneration is observed within the tendon itself. We aimed to summarize the current state of knowledge on tendinopathies including potential triggers, trails, end-state and treatment options
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