Download or read book Inflammation and tendon healing written by Parmis Blomgran and published by Linköping University Electronic Press. This book was released on 2017-10-30 with total page 45 pages. Available in PDF, EPUB and Kindle. Book excerpt: Tendons heal through three different overlapping phases; the inflammatory, proliferative and remodeling phase. Many studies have investigated what factors influence healing of tendons. However, little was known about inflammation and the immune cells present during Achilles tendon healing by the time this thesis started. We developed a flow cytometry method for our rat model of tendon healing, which enabled us to study different leukocyte subpopulations during Achilles tendon healing. The general aim of this thesis was to understand more about inflammation and the immune cell populations present during tendon healing and how the immune cell composition changes during normal tendon healing. Moreover, we investigated how different factors that are known to influence tendon healing affected the composition of the immune cell population. First, we described the immune cells during the time course of tendon healing focusing on different subpopulations of macrophages and T cells. Then, we studied how these cells were influenced by reduced mechanical loading. Mechanical loading prolonged the presence of M1 macrophages and delayed the switch to regulatory T cells and M2 macrophages compared to reduced mechanical loading. Next, the effect of nonsteroidal anti-inflammatory drugs (NSAIDs) on the leukocyte composition revealed that, even though NSAIDs influence the mechanical properties of healing tendon, this effect was not mediated via changes in the leukocyte sub-populations during early and mid-time tendon healing. Further, the effect of corticosteroids during the inflammatory and remodeling phases of tendon healing was an improved healing of tendons and a reduction of CD8a T cells when corticosteroid was administered after the inflammatory phase. Lastly, we investigated if impairment of tendon healing by NSAIDs was related to mechanotransduction or microdamage during mechanical loading and showed that NSAIDs impair tendon healing by reducing the response to microdamage. In conclusion, these studies show that inflammation plays an important role during Achilles tendon healing, and factors that influence healing can also alter the presence or polarization of immune cell populations.
Download or read book Tendon Healing written by Malin Hammerman and published by Linköping University Electronic Press. This book was released on 2018-02-20 with total page 35 pages. Available in PDF, EPUB and Kindle. Book excerpt: Mechanical loading and the inflammatory response during tendon healing might be important for the healing process. Mechanical loading can improve the healing tendon but the mechanism is not fully understood. The aim of this thesis was to further clarify the effect of mechanical loading on tendon healing and how mechanical loading affects the inflammatory response during the healing process. We used a rat Achilles tendon model to study healing. The rats were exposed to different degrees of loading by unloading methods such as paralysis of the calf muscles with Botox, tail suspension, and an orthosis (a boot). Full loading was achieved by free cage activity or treadmill walking. Microdamage in tendons, unloaded with Botox, was also investigated by needling. The healing tendons were evaluated in a materials testing machine (to analyze the mechanical properties), by gene expression analysis (microarray and PCR), or histology. Our results show that moderate loading (unloading with Botox) improves the mechanical properties of healing tendons compared to minimal loading (unloading with Botox in combination with tail suspension or a boot), especially the material properties. In accordance to these findings, expression of extracellular matrix genes were also increased by moderate compared to minimal loading. Full loading improved all mechanical properties and the expression of extracellular matrix genes was further increased compared to moderate loading. However, structural properties, such as the strength and the size of the healing tendon, were more affected by full loading. Full loading also affected the expression of inflammation-related genes during the early healing phase, 3 and 5 days after tendon injury, and increased the number of immune cells in the healing tendon tissue. Also microdamage of the healing tendon (detected by blood leakage) was increased by full loading compared to moderate loading during the early healing phase. Induced microdamage by repeated needling in the healing tendon tissue increased the structural properties of the healing tendon. The gene expression after needling was similar to the gene expression after full loading. The improvement of mechanical properties by loading in healing tendons was decreased by an anti-inflammatory drug called parecoxib, which decreases the production of prostaglandins by inhibiting COX-2 activity. The effect of parecoxib was reduced when loading was reduced but we could not confirm that the effect of parecoxib was related to the degree of loading. However, parecoxib abolished the stimulatory effect of microdamage. In conclusion, these studies show that moderate loading improves the quality of the healing tendon whereas full loading also increases the quantity of the healing tendon tissue. Full loading creates microdamage and increases inflammation during the early healing phase. The strong effect of full loading on the structural properties might be due to microdamage. Indeed, the anti-inflammatory drug parecoxib seems to impair mechanical stimulation of healing tendons by reducing the response to microdamage.
Download or read book Inflammation and Tendon Healing written by Parmis Blomgran and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Tendons heal through three different overlapping phases; the inflammatory, proliferative and remodeling phase. Many studies have investigated what factors influence healing of tendons. However, little was known about inflammation and the immune cells present during Achilles tendon healing by the time this thesis started. We developed a flow cytometry method for our rat model of tendon healing, which enabled us to study different leukocyte subpopulations during Achilles tendon healing. The general aim of this thesis was to understand more about inflammation and the immune cell populations present during tendon healing and how the immune cell composition changes during normal tendon healing. Moreover, we investigated how different factors that are known to influence tendon healing affected the composition of the immune cell population. First, we described the immune cells during the time course of tendon healing focusing on different subpopulations of macrophages and T cells. Then, we studied how these cells were influenced by reduced mechanical loading. Mechanical loading prolonged the presence of M1 macrophages and delayed the switch to regulatory T cells and M2 macrophages compared to reduced mechanical loading. Next, the effect of nonsteroidal anti-inflammatory drugs (NSAIDs) on the leukocyte composition revealed that, even though NSAIDs influence the mechanical properties of healing tendon, this effect was not mediated via changes in the leukocyte sub-populations during early and mid-time tendon healing. Further, the effect of corticosteroids during the inflammatory and remodeling phases of tendon healing was an improved healing of tendons and a reduction of CD8a T cells when corticosteroid was administered after the inflammatory phase. Lastly, we investigated if impairment of tendon healing by NSAIDs was related to mechanotransduction or microdamage during mechanical loading and showed that NSAIDs impair tendon healing by reducing the response to microdamage. In conclusion, these studies show that inflammation plays an important role during Achilles tendon healing, and factors that influence healing can also alter the presence or polarization of immune cell populations.
Download or read book Tendon Regeneration written by Manuela E. Gomes and published by Academic Press. This book was released on 2015-08-08 with total page 471 pages. Available in PDF, EPUB and Kindle. Book excerpt: Tendon Regeneration: Understanding Tissue Physiology and Development to Engineer Functional Substitutes is the first book to highlight the multi-disciplinary nature of this specialized field and the importance of collaboration between medical and engineering laboratories in the development of tissue-oriented products for tissue engineering and regenerative medicine (TERM) strategies. Beginning with a foundation in developmental biology, the book explores physiology, pathology, and surgical reconstruction, providing guidance on biological approaches that enhances tendon regeneration practices. Contributions from scientists, clinicians, and engineers who are the leading figures in their respective fields present recent findings in tendon stem cells, cell therapies, and scaffold treatments, as well as examples of pre-clinical models for translational therapies and a view of the future of the field. Provides an overview of tendon biology, disease, and tissue engineering approaches Presents modern, alternative approaches to developing functional tissue solutions discussed Includes valuable information for those interested in tissue engineering, tissue regeneration, tissue physiology, and regenerative medicine Explores physiology, pathology, and surgical reconstruction, building a natural progression that enhances tendon regeneration practices Covers recent findings in tendon stem cells, cell therapies, and scaffold treatments, as well as examples of pre-clinical models for translational therapies and a view of the future of the field
Download or read book Tendon and Ligament Healing written by William Weintraub and published by Redwing Book Company. This book was released on 2003 with total page 249 pages. Available in PDF, EPUB and Kindle. Book excerpt: In 25 years of practicing structural/osteopathic manual therapy the author has done considerable work with seriously damaged tendons and ligaments, and has achieved results that conventional medicine would rate as improbable. Over time, he has developed a therapeutic model for treating these injuries so that individuals with chronic conditions -- who have exhausted the standard physiotherapy options and are facing surgery -- can have a viable option for recovery. His techniques, based on basic principles of structural healthcare, emphasize the importance of precise anatomical focus and the capacity to work with subtle changes of structure. Of essential importance is combining detailed specific treatment of the small fibers and tissues of the local injury area with an overall approach to improving larger body patterns and tensions. Logically, the responsiveness and self-corrective capacity of body tissues when given proper conditions is also an important factor. The primary techniques used are the osteopathic methods of strain-counterstrain, cranial and visceral osteopathy, and fascial release, as well as body-mind centering, zero balancing, and acupressure. His clinical model, which represents a new approach to serious, chronic tendon and ligament injuries, is based on these techniques, their combinations and specific usage, and the skills and aptitudes necessary for applying these techniques, including certain perceptual skills and a thorough knowledge of anatomy and kinesiology. Weintraub's descriptions are vital, interesting, alive, absorbing, even dramatic. He discusses at great length the nature of the tendons and ligaments, describes his manual therapy model -- comparing it with conventional medical procedures -- and covers processes and tissue changes in tendon/ligament healing as related to manual therapy. Case studies, self-help strategies, and thoughtful words on clinical efficacy and future directions in the field make for a thorough and well-rounded presentation. (Product Description).
Download or read book Modulating Inflammation During Tendon To Bone Healing Via IKK Inhibition written by and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: INTRODUCTION: More than 250,000 rotator cuff repairs are performed annually, yet successful healing of tendon-to-bone attachment is rarely achieved [1]. Although low levels of inflammatory cytokines are important in initiating the repair process, excessive inflammation, commonly seen in adult tendinopathy, impairs healing outcomes [2]. The nuclear factor u03baB (NF-u03baB) signaling pathway has been implicated in the early phases of tendon degeneration, and dramatic up regulation of this inflammatory pathway is seen during tendon healing [3,4]. Specifically inhibiting the inflammatory IKKu03b2-dependent mechanisms of NF-u03baB signaling, rather than complete inhibition of the pathway, following repair may improve clinical outcomes. Therefore, the objective of this study was to evaluate the therapeutic potential of IKKu03b2 inhibition for managing the excessive inflammation that persists after rotator cuff repair and thereby enhance tendon-to-bone healing.METHODS: Patient biopsy cell culture: Human study protocol were approved by the Ethics Committee under ACA No.99/101. Full informed consent was obtained from all patients. Primary tendon cells were isolated from hamstring tendons (n=3, ages:22-44y) taken from patients undergoing anterior cruciate ligament autograft surgery. Cells were isolated, passed to P2, plated, expanded for 48h, and treated with 1 ng Interleukin-1u03b2, 50M IKKu03b2 Inhibitor, or both for 4 hours, and compared to vehicle-treated controls. The supernatant was collected to evaluate inflammatory cytokine concentration. One-way ANOVA with Dunnetu2019s post-hoc analysis was performed to compare cytokine production. Rotator cuff animal model: A total of 52 adult Sprague-Dawley rats were used, as approved by the Columbia University Institutional Animal Care and Use Committee. Bilateral surgical supraspinatus tendon injury-and-repair was performed, as previously described [5]. 42 rats were injured and repaired and 10 rats were used as healthy normal controls (Normal group). Surgical animals were either left untreated (CTRL group) or administered IKKu03b2 small molecule inhibitor (ACHP Hydrochloride) dissolved in 0.5 % sodium carboxymethyl cellulose (Sigma). The IKKu03b2 inhibitor was delivered orally (5 mg/kg) once a day for 7 days after surgery (ACHP group). Following acute injury and repair, all animals were allowed free cage activity and sacrificed after 3 days, 14 days, or 28 days of healing. Gene expression outcomes for the tendon-to-bone attachment site were evaluated at all time points. A subset of samples from each time point were processed for histology to evaluate healing at the repair site. Two-way ANOVAs (for group and time) were performed to compare gene expression levels. p
Download or read book Tendon Injuries written by Nicola Maffulli and published by Springer Science & Business Media. This book was released on 2005-02-09 with total page 372 pages. Available in PDF, EPUB and Kindle. Book excerpt: Tendon ailments are a significant cause of morbidity among athletes of all levels and are increasing in prevalence. Their management is often empirical, and para-scientific, only looking at the biological aspects of tendon ailments. This book conveys a comprehensive and concise body of knowledge on the management of tendon problems in sportspeople with practical details of clinical protocols. Tendon Injuries: Basic Science and Clinical Medicine is specifically dedicated to the clinical aspects of tendinopathy and provides the required knowledge and scientific basis for the sports medicine practitioner, orthopedic specialist and student facing upper and lower limb tendon ailments in athletes. A comprehensive review of tendon disorders is given and modern criteria of management outlined to form the basis of effective clinical management of this group of patients.
Download or read book Anti inflammatory Effect of Adipose derived Mesenchymal Stem Cells for Flexor Tendon Healing written by Cionne Nirit Manning and published by . This book was released on 2013 with total page 199 pages. Available in PDF, EPUB and Kindle. Book excerpt: Despite advances in surgical techniques over the past three decades, tendon repairs remain prone to poor clinical outcomes. While previous attempts to improve flexor tendon healing have focused on the later stages of healing (i.e., proliferation and matrix synthesis), the early inflammatory phase of tendon healing remains poorly understood and its modulation during healing has not yet been studied. The overall goal of this work is therefore to determine whether flexor tendon healing can be enhanced through modulation of the inflammatory environment after surgical repair. To meet this objective, the inflammatory response after flexor tendon injury and repair was first characterized to help identify inflammation-related targets for future treatments. Temporal changes in immune cell population and gene expression of inflammation-, matrix degradation-, and extracellular matrix-related factors were examined. Of the observed changes, the most dramatic effect was the greater than 4000-fold up-regulation in the expression of the pro-inflammatory factor IL-1[beta]. While some inflammation is essential for healing to occur, such high levels of pro-inflammatory cytokines may result in collateral tissue damage and impair tendon healing. To examine the effect of inflammatory cytokines on tendon fibroblasts, the native cell type that must eventually re-build the injured tendon, we established two in vitro models of inflammation: one induced by exogenous IL-1[beta] and one induced by macrophages (the primary cellular source of IL-1[beta]). We found that IL-1[beta] and other pro-inflammatory cytokines secreted by macrophages induce further up-regulation of pro-inflammatory factors by tendon fibroblasts. Furthermore, exposure of tendon fibroblasts to an inflammatory environment led to up-regulation of factors related to matrix degradation and down-regulation of factors related to extracellular matrix formation. These changes in expression are likely detrimental to tendon healing in vivo. In an effort to reduce the negative effects of inflammatory cytokines on tendon fibroblasts, adipose-derived mesenchymal stem cells (ASCs) were incorporated into the two in vitro models and their ability to modulate inflammation was investigated. While ASCs were unable to counteract the effects of IL-1[beta] directly, ASC co-culture with macrophages successfully suppressed the negative effects of macrophages on tendon fibroblasts. FACS analysis revealed that ASCs induced a phenotypic switch from a pro-inflammatory macrophage phenotype to an anti-inflammatory macrophage phenotype, thus resulting in exposure of tendon fibroblasts to fewer pro-inflammatory cytokines. In order to translate these in vitro findings in vivo, a surgically manageable scaffold capable of delivering and retaining ASCs at the repair site was developed. The fibrin/nanofiber scaffolds were well-tolerated in the in vivo flexor tendon repair setting and successful delivery of ASCs was achieved. Pilot data demonstrated promise with this approach, as demonstrated by down-regulation of IL-1[beta] and MMP1 in the ASC treated animals. However, the pilot study was underpowered, and additional animals and assays are required to fully evaluate the effect of ASCs in vivo.
Download or read book Tendon Injury and Repair written by Terry S. Saxby and published by . This book was released on 2007 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Tendon problems are a common cause of foot and ankle pathology. In the past decade there has been significant advances in the management of these problems. This has been achieved not only by an improvement of surgical techniques but also through a better understanding of tendon injury and healing. In this issue we will review the recent advances in the diagnosis and treatment of common tendon problems beginning with a review of tendon healing. This issue will provide the reader with an excellent review of all that is new on this topic.
Download or read book Metabolic Influences on Risk for Tendon Disorders written by Paul W. Ackermann and published by Springer. This book was released on 2016-08-17 with total page 299 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book will be of considerable interest to students, practitioners (Doctors, Physiotherapists, and other health care professionals), and researchers who deal with the complex structure of tendons and the need to effectively address tendon disorders. The book is divided into three sections: (1) Basic Biology and Biochemical Markers; (2) Metabolic Disorders; and (3) Novel Therapies. The first section, devoted to the basic biology of tendons, is aimed at those individuals who want to gain basic information on tendons and the subsection on biochemical markers is chiefly aimed at researchers who are developing new studies within this field. The section on metabolic disorders is mainly directed at practitioners who desire to know how metabolic disorders can affect tendons in order to optimize treatment for their patients. Finally, the section on novel therapies is focused on some new treatment options within this field, and discussions regarding how management of tendon disorders needs to incorporate perspectives on current understanding of tendon metabolism.
Download or read book Tendinopathy in Athletes written by Savio L-Y. Woo and published by John Wiley & Sons. This book was released on 2008-04-15 with total page 248 pages. Available in PDF, EPUB and Kindle. Book excerpt: This concise volume in the Encyclopaedia of Sports Medicine series, published under the auspices of the International Olympic Committee, provides a dependable source of current knowledge available on tendinopathy and covers both the basic science and clinical aspects of the subject. Despite its high incidence, the precise etiopathogenesis and effective treatment of tendinopathy remain elusive. Tendinopathy in Athletes draws on the expertise of an international and prolific collection of contributors, both clinicians and scientists, who provide new insights into this specialized area. This book: provides a comprehensive resource for both clinicians and researchers with information organized logically, with an easy-to-follow progression from the basic scientific findings to clinical applications discusses the full range of treatment modalities, including new molecular and biological approaches, plus surgical and alternative approaches to tendinopath contains “What We Need to Know” sections that suggest future areas of research for young investigators. As tendinopathy remains one of the most common injuries encountered, both in sports and at the workplace, this essential volume is sure to be a source of frequent consultation.
Download or read book Bio orthopaedics written by Alberto Gobbi and published by Springer. This book was released on 2017-05-26 with total page 677 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book introduces the exciting field of orthobiology, which will usher in a new array of therapeutic approaches that stimulate the body’s natural resources to regenerate musculoskeletal tissues damaged by trauma or disease. The book addresses a range of key topics and discusses emerging approaches that promise to offer effective alternatives to traditional treatments for injuries to bone, cartilage, muscles, ligaments, and tendons. It explains in detail how a variety of innovative products, including biomaterials, growth factors, and autogenous cells, together provide the basis for the regeneration of these musculoskeletal structures and how recent scientific progress has created unique opportunities to address pathological situations that until recently have been treated with unsatisfactory results. The authors are experts from across the world who come together to provide a truly global overview. The book is published in collaboration with ISAKOS. It will be invaluable for all with an interest in this area of medicine, which has already attained huge popularity in Orthopaedics and Sports Medicine and has also attracted the attention of the lay public.
Download or read book Sports Injuries written by Mahmut Nedim Doral and published by Springer Nature. This book was released on 2015-06-29 with total page 3295 pages. Available in PDF, EPUB and Kindle. Book excerpt: Sports Injuries: Prevention, Diagnosis, Treatment and Rehabilitation covers the whole field of sports injuries and is an up-to-date guide for the diagnosis and treatment of the full range of sports injuries. The work pays detailed attention to biomechanics and injury prevention, examines the emerging treatment role of current strategies and evaluates sports injuries of each part of musculoskeletal system. In addition, pediatric sports injuries, extreme sports injuries, the role of physiotherapy, and future developments are extensively discussed. All those who are involved in the care of patients with sports injuries will find this textbook to be an invaluable, comprehensive, and up-to-date reference.
Download or read book Atlas of Uncommon Pain Syndromes E Book written by Steven D. Waldman and published by Elsevier Health Sciences. This book was released on 2019-09-19 with total page 488 pages. Available in PDF, EPUB and Kindle. Book excerpt: Covering the many relatively uncommon pain conditions that are often misdiagnosed, this one-of-a-kind visual resource clearly presents the extensive knowledge and experience of world-renowned pain expert Steven D. Waldman, MD, JD. Atlas of Uncommon Pain Syndromes, 4th Edition, first and foremost helps you make a correct diagnosis – a critical step in managing patients in chronic pain. Hundreds of high-quality illustrations, as well as x-rays, ultrasound, CTs, and MRIs, help you confirm your diagnoses with confidence. Offers head-to-toe coverage – 135 conditions in all – providing concise, easy-to-read chapters for each condition. Dr. Waldman’s practical guidance is designed to help you make the correct diagnosis of uncommon pain syndromes, even the signs and symptoms don’t quite fit. Explains each pain syndrome using a consistent, easy-to-follow format: an ICD-10 CM code for billing purposes, followed by a brief description of the signs and symptoms, laboratory and radiographic testing, differential diagnosis, available treatment options, and clinical pearls. Features updated chapters throughout, as well as 12 new chapters covering Hemicrania Continua, Acute Calcific Prevertebral Tendinitis, Sternohyoid Syndrome Snapping Scapula Syndrome, Erythromelagia, Foix-Alajouanine Syndrome, Lumbar Paraspinous Muscle Compartment Syndrome, Clunealgia, Nutcracker Syndrome, Paroxysmal Extreme Pain Disorder, Iliopsoas Tendon Rupture, and Snapping Pes Anserinus Syndrome Provides practitioners and trainees in pain medicine, anesthesiology, neurology, psychiatry, physical medicine and rehabilitation, primary care, and more with a firm foundation in the diagnosis of uncommon pain in daily practice.
Download or read book Tendons written by Hasan Sözen and published by BoD – Books on Demand. This book was released on 2019-12-04 with total page 166 pages. Available in PDF, EPUB and Kindle. Book excerpt: Mankind has reached its present physical form through evolution of the movement system. Muscles, bones, and joints are the most important components of the movement system. Muscles are active elements, while bones and joints are passive elements. But to bring about movement, these three elements must work together. Tendons are round, oval, or flat tissues that connect muscles to bones. Muscle, tendon, or ligament injuries prevent motion so this is an important issue in trauma. If muscle, tendon, or ligament injuries occur together with vessel or nerve injury, it may be life threatening. The cause of injury might differ from a simple sports injury to a serious traffic accident. Muscles, bones, and joints have taken their place in the literature, but it would be wrong to say the same for tendons. This book describes tendons from different perspectives, thus providing the missing information in the literature. I hope that this book will be useful for anyone who wants to read about new perspectives on tendons. I also hope that it will inspire researchers working in this field.
Download or read book Sports induced Inflammation written by Wayne B. Leadbetter and published by . This book was released on 1990 with total page 824 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Arthroscopy and Sport Injuries written by Piero Volpi and published by Springer. This book was released on 2016-01-01 with total page 449 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book describes the current applications of arthroscopy in a very wide range of sports injuries involving, among other sites, the hip, knee, ankle, shoulder, elbow, and wrist. For each condition, mechanisms of injury are explained and the role of arthroscopy in diagnosis and treatment is described. Relevant information is also provided on the epidemiology and mechanisms of injury in specific sports and on indications for treatment and rehabilitation. The book fully reflects the recent advances that have taken place in arthroscopy, permitting more accurate assessment and more successful management of post-traumatic pathologies. Furthermore, it acknowledges that as a result of the increasing use of new technologies and biomaterials, there is now particular interest in techniques that promote biological healing of articular lesions and permit complete functional recovery. The authors are leading specialists in the field who have aimed to provide practitioners with the clear guidance that they require on the evaluation and treatment of injuries incurred during sporting activity.
