Tendon injury

肌腱损伤
  • 文章类型: Journal Article
    由于肌腱细胞外基质(ECM)组成的变化,肌腱的生物力学特性受到影响。年龄,过度使用,创伤和代谢紊乱是导致肌腱异常的一些相关疾病。高脂血症是导致生物力学受损的主要因素之一。高脂血症猪的冈下肌腱受伤。8周后(i)从损伤部位的冈下肌腱,(ii)来自对侧的冈下肌腱和(iii)跟腱,收集并分析了构成生物力学特性主要部分的ECM成分。脊髓下腱在损伤部位的免疫染色有较高的染色1型胶原(COL1A1),biglycan,脯氨酸4-羟化酶和莫霍克,但核心蛋白聚糖的染色低于对照组。在冈下肌腱上受伤的猪的跟腱显示出对负荷的慢性适应,这从更有组织的ECM中可以明显看出,莫霍克和减少的biglycan,scleraxis。需要通过生物力学特性详细研究胶原蛋白周转和对负荷的慢性适应背后的机制。
    The biomechanical properties of the tendon are affected due to the changes in composition of the tendon extracellular matrix (ECM). Age, overuse, trauma and metabolic disorders are a few associated conditions that contribute to tendon abnormalities. Hyperlipidemia is one of the leading factors that contribute to the compromised biomechanical. Injury was made on infraspinatus tendon of hyperlipidemic swines. After 8 weeks (i) infraspinatus tendon from the injury site, (ii) infraspinatus tendon from the contralateral side and (iii) Achilles tendon, were collected and analyzed for ECM components that form the major part in biomechanical properties. Immunostaining of infraspinatus tendon on the injury site had higher staining collagen type-1 (COL1A1), biglycan, prolyl 4-hydroxylase and mohawk but lower staining for decorin than the control group. The Achilles tendon of the swines that had injury on infraspinatus tendon showed a chronic adaptation towards load which was evident from a more organized ECM with increased decorin, mohawk and decreased biglycan, scleraxis. The mechanism behind the collagen turnover and chronic adaptation to load need to be studied in detail with the biomechanical properties.
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  • 文章类型: Journal Article
    除了疼痛的感觉,周围神经已被证明在组织再生和修复中起关键作用。作为一个高度神经支配的器官,骨骼可以从损伤中恢复而不会形成疤痕,使其成为研究神经在组织再生中的作用的有趣模型。作为比较,肌腱是一种神经支配不足的肌肉骨骼组织,修复通常导致疤痕形成。这里,我们回顾了神经支配在损伤修复的三个阶段(炎症,修复,和重塑)在两种常见的肌肉骨骼组织中:骨骼和肌腱。基于这一重点审查,我们得出的结论是,外周神经支配对于适当的骨和肌腱修复阶段至关重要,并且神经可以通过多种神经肽或神经递质与损伤微环境的相互作用来动态调节修复过程。对肌肉骨骼修复的神经元调节有更深入的了解,神经和肌肉骨骼系统之间的串扰,将能够开发未来的组织愈合疗法。
    越来越多的证据表明,跨器官系统,周围神经调节组织修复和再生的过程。这在诸如影响骨骼和肌腱的肌肉骨骼损伤的情况下尤其相关。然后出现了问题:周围神经支配在骨和肌腱损伤修复中的作用是什么?这篇综述深入探讨了神经在各个恢复阶段调节骨和肌腱损伤愈合的方式。对神经对这些组织修复的影响的更深入的理解可以为未来组织愈合的治疗策略的发展铺平道路。
    Beyond the sensation of pain, peripheral nerves have been shown to play crucial roles in tissue regeneration and repair. As a highly innervated organ, bone can recover from injury without scar formation, making it an interesting model in which to study the role of nerves in tissue regeneration. As a comparison, tendon is a musculoskeletal tissue that is hypo-innervated, with repair often resulting in scar formation. Here, we reviewed the significance of innervation in three stages of injury repair (inflammatory, reparative, and remodeling) in two commonly injured musculoskeletal tissues: bone and tendon. Based on this focused review, we conclude that peripheral innervation is essential for phases of proper bone and tendon repair, and that nerves may dynamically regulate the repair process through interactions with the injury microenvironment via a variety of neuropeptides or neurotransmitters. A deeper understanding of neuronal regulation of musculoskeletal repair, and the crosstalk between nerves and the musculoskeletal system, will enable the development of future therapies for tissue healing.
    Accumulating evidence has shown that, across organs systems, peripheral nerves regulate the process of tissue repair and regeneration. This is particularly relevant in the context of musculoskeletal injuries such as those affecting the bone and tendon. The question then arises: what is the function of peripheral innervation in the repair of bone and tendon injuries? This review offers an in-depth look at the ways in which nerves regulate the healing of bone and tendon injuries at various stages of recovery. A deeper comprehension of the influence of nerves on the repair of these tissues could pave the way for the development of future therapeutic strategies for tissue healing.
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  • 文章类型: Journal Article
    肌腱是肌肉骨骼系统的重要组成部分,促进运动和支持机械负荷。新出现的证据表明维生素D,除了其在骨骼健康中公认的作用之外,对肌腱生理有显著影响。本手稿的目的是回顾维生素D对肌腱的影响,着眼于其行动机制,临床意义,和治疗应用。对科学电子数据库进行了全面搜索,以确定有关维生素D对肌腱健康影响的文章。本综述包括14项研究。在体外进行了五项研究,并在体内进行了九项研究。尽管有一些相互矛盾的结果,纳入的研究表明,维生素D调节胶原蛋白的合成,炎症,并通过与维生素D受体的相互作用在肌腱内矿化。流行病学研究将维生素D缺乏与肌腱疾病联系起来,包括肌腱病和愈合受损。补充维生素D有望改善肌腱的力量和功能,特别是在运动员和老年人等高危人群中。未来的研究应该解决最佳补充策略,并探索维生素D与其他影响肌腱健康的因素之间的相互作用。将维生素D优化整合到临床实践中可以增强肌腱完整性并减轻肌腱相关病变的负担。
    Tendons are vital components of the musculoskeletal system, facilitating movement and supporting mechanical loads. Emerging evidence suggests that vitamin D, beyond its well-established role in bone health, exerts significant effects on tendon physiology. The aim of this manuscript is to review the impact of vitamin D on tendons, focusing on its mechanisms of action, clinical implications, and therapeutic applications. A comprehensive search of scientific electronic databases was conducted to identify articles on the effects of vitamin D on tendon health. Fourteen studies were included in this review. Five studies were performed in vitro, and nine studies were conducted in vivo. Despite some conflicting results, the included studies showed that vitamin D regulates collagen synthesis, inflammation, and mineralization within tendons through its interaction with vitamin D receptors. Epidemiological studies link vitamin D deficiency with tendon disorders, including tendinopathy and impaired healing. Supplementation with vitamin D shows promise in improving tendon strength and function, particularly in at-risk populations such as athletes and the elderly. Future research should address optimal supplementation strategies and explore the interplay between vitamin D and other factors influencing tendon health. Integrating vitamin D optimization into clinical practice could enhance tendon integrity and reduce the burden of tendon-related pathologies.
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  • 文章类型: Journal Article
    异位骨化(HO),软组织如肌腱和肌肉内骨的病理形成,是严重损伤引起的明显并发症。虽然软组织损伤是HO发育所必需的,创伤诱导HO的具体分子病理学仍是个谜.先前的研究在肌腱HO的早期阶段检测到异常的自噬功能。然而,自噬是否支配HO产生过程尚待确定。这里,采用创伤诱导肌腱HO模型研究自噬与肌腱钙化的关系。在肌腱切开术的早期阶段,据观察,自噬通量显著受损,阻断自噬通量促进了更猖獗的钙化的发展。此外,Gt(ROSA)26sor转基因小鼠模型实验揭示了溶酶体酸功能障碍是自噬通量受损的主要原因。刺激V-ATPase活性恢复溶酶体酸功能和自噬通量,从而逆转肌腱HO。本研究表明,自噬-溶酶体功能障碍在肌腱损伤阶段引发HO,对HO具有潜在的治疗靶向意义。
    Heterotopic ossification (HO), the pathological formation of bone within soft tissues such as tendon and muscle, is a notable complication resulting from severe injury. While soft tissue injury is necessary for HO development, the specific molecular pathology responsible for trauma-induced HO remains a mystery. The previous study detected abnormal autophagy function in the early stages of tendon HO. Nevertheless, it remains to be determined whether autophagy governs the process of HO generation. Here, trauma-induced tendon HO model is used to investigate the relationship between autophagy and tendon calcification. In the early stages of tenotomy, it is observed that autophagic flux is significantly impaired and that blocking autophagic flux promoted the development of more rampant calcification. Moreover, Gt(ROSA)26sor transgenic mouse model experiments disclosed lysosomal acid dysfunction as chief reason behind impaired autophagic flux. Stimulating V-ATPase activity reinstated both lysosomal acid functioning and autophagic flux, thereby reversing tendon HO. This present study demonstrates that autophagy-lysosomal dysfunction triggers HO in the stages of tendon injury, with potential therapeutic targeting implications for HO.
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  • 文章类型: Journal Article
    由于肌腱的自我再生能力有限,肌腱损伤通常会导致关节功能障碍。修复肌腱是外科医生面临的主要挑战,并给社会带来了巨大的经济负担。因此,迫切需要制定有效的修复受损肌腱的策略。使用水凝胶的肌腱组织工程已成为一种有前途的方法,引起了极大的兴趣。水凝胶具有优异的生物相容性和生物降解性,使它们能够为细胞创造类似细胞外基质的生长环境。它们还可以作为细胞或其他物质的载体,以加速肌腱修复。在过去的十年里,许多研究在制备用于肌腱愈合的水凝胶支架方面取得了重大进展。这篇综述旨在概述用于肌腱组织工程的基于水凝胶的支架材料的最新研究,并讨论基于它们的递送系统。
    Tendon injuries often lead to joint dysfunction due to the limited self-regeneration capacity of tendons. Repairing tendons is a major challenge for surgeons and imposes a significant financial burden on society. Therefore, there is an urgent need to develop effective strategies for repairing injured tendons. Tendon tissue engineering using hydrogels has emerged as a promising approach that has attracted considerable interest. Hydrogels possess excellent biocompatibility and biodegradability, enabling them to create an extracellular matrix-like growth environment for cells. They can also serve as a carrier for cells or other substances to accelerate tendon repair. In the past decade, numerous studies have made significant progress in the preparation of hydrogel scaffolds for tendon healing. This review aims to provide an overview of recent research on the materials of hydrogel-based scaffolds used for tendon tissue engineering and discusses the delivery systems based on them.
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  • 文章类型: Journal Article
    手部手术后的粘连很常见,导致刚度,这损害了患者的功能结果。这项研究的目的是进行系统评价,以分析抗粘连屏障在手外伤手术中的作用。使用PubMed/MEDLINE进行了全面的文献检索,Embase和Cochrane中央控制试验登记册,符合系统评价和荟萃分析指南的首选报告项目。纳入标准包括18岁或以上患者的随机和非随机对照研究,在手外伤患者中,与无屏障的传统修复相比,使用抗粘连屏障进行干预,包括神经,骨折,和肌腱损伤。感兴趣的主要结果指标是手术后的运动范围(ROM)。感兴趣的次要结果包括进一步手术,报告的刚度,并发症,生活质量,是时候回去工作了。共确定了8450条记录;7项研究符合资格标准并被纳入。审查中包括七个抗粘连屏障。三个特工(羊膜,MASTBioproughsSurgiwrap防粘薄膜,和无细胞真皮基质[ADM])显示出术后ROM的统计学显着改善;但是,所有3项研究均显示存在偏倚风险.这篇综述强调了缺乏高质量的研究,这些研究表明在手外科中使用抗粘连屏障具有明显的优势;然而,有一些证据表明羊膜,MAST粘连屏障膜和ADM作为手外科的抗粘连屏障可能具有良好的效果,但是需要进一步的高质量研究来量化这种影响。
    Adhesions following hand surgery are common, leading to stiffness, which compromises the functional outcomes for the patient. The objective of this study was to conduct a systematic review to analyze the role of antiadhesive barriers in surgery for hand trauma. A comprehensive literature search was conducted using PubMed/MEDLINE, Embase and the Cochrane Central Register of Controlled Trials, in line with the Preferred Reporting Items for Systematic reviews and Meta-Analysis guidelines. The inclusion criteria included both randomized and non-randomized control studies in patients aged 18 or over, with the intervention of an anti-adhesive barrier compared against traditional repair without a barrier in patients with hand trauma, including nerve, fracture, and tendon injury. The primary outcome measure of interest was range of movement (ROM) after operative surgery. Secondary outcomes of interest included further surgery, reported stiffness, complications, quality of life, and time to return to work. A total of 8450 records were identified; 7 studies fulfilled the eligibility criteria and were included. Seven anti-adhesive barriers were included in the review. Three agents (amnion, MASTBiosurgery Surgiwrap antiadhesive film, and acellular dermal matrix [ADM]) demonstrated statistically significant improvements in ROM postoperatively; however, all 3 studies demonstrated a risk of bias. This review highlights the paucity of high-quality studies demonstrating any clear advantage of using anti-adhesive barriers in hand surgery; however, there is some evidence to suggest that amnion, the MAST adhesion barrier film and ADM may have favorable results as an antiadhesive barrier in hand surgery, but further high-quality research is required to quantify this effect.
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  • 文章类型: Case Reports
    Sever\的疾病,或者跟骨关节炎,是体力活动儿童足跟疼痛的常见原因。这份病例报告介绍了评估,诊断,以及一名10岁女性患者持续左足跟疼痛的治疗。临床检查和超声诊断证实了Sever病的诊断。治疗涉及全面的方法,包括药物,固定化,治疗方式,和练习。患者在治疗10周后表现出改善。这个案例强调了早期识别的意义,准确诊断,和多模式管理,以成功治疗Sever病。
    Sever\'s disease, or calcaneal apophysitis, is a common cause of heel pain in physically active children. This case report presents the evaluation, diagnosis, and management of a 10-year-old female patient with persistent left heel pain. Clinical examination and diagnostic ultrasound confirmed the diagnosis of Sever\'s disease. Treatment involved a comprehensive approach, including medication, immobilization, therapy modalities, and exercises. The patient showed improvement after 10 weeks of therapy. This case emphasizes the significance of early recognition, accurate diagnosis, and multimodal management for successful outcomes in Sever\'s disease.
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  • 文章类型: Case Reports
    肱二头肌肌腱(DBT)的远端断裂占肱二头肌断裂的3%。诊断通常依赖于高度临床怀疑和补充影像学研究,>90%的病例记录在第四到第六十年的男性中。女性DBT破裂的报道很少,主要涉及部分和退行性损伤。这里,我们提出了一个前所未有的案例,一名28岁的女性专业混合武术运动员患有完全外伤性DBT破裂。运动员使用锚固件重新连接技术进行了手术修复。未观察到并发症,运动员表现出令人满意的结果,2周后被清除进行物理治疗,并在术后3个月后恢复运动。
    The distal rupture of the biceps brachii muscle tendon (DBT) accounts for 3% of biceps ruptures. Diagnosis typically relies on high clinical suspicion and complementary imaging studies, with >90% of cases documented in males between the fourth and sixth decades of life. Reports of DBT ruptures in females are scarce, mostly involving partial and degenerative injuries. Here, we present an unprecedented case of a 28-year-old female professional mixed martial arts athlete with a total traumatic DBT rupture. The athlete underwent surgical repair using anchor reattachment technique. No complications were observed, and the athlete showed satisfactory outcomes, being cleared for physiotherapy after 2 weeks and returning to sports after a 3-month postoperative period.
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  • 文章类型: Journal Article
    背景:相关证据表明,血管生成因子对肌腱韧带物理损伤后的原纤维基质重建有显著贡献。血管内皮生长因子A(VEGFA),凭借其强大的血管生成作用,已经被广泛研究,及其功能多态性,包括rs699947,rs1570360和rs2010963,一直是众多调查的焦点。一些学者探讨了VEGFA基因多态性与肌腱韧带损伤风险的关系,但是研究结果并不完全一致。
    目的:本研究的目的是研究VEGFA中rs699947,rs1570360和rs2010963基因多态性与肌腱和韧带损伤风险之间的关系。
    方法:在根据搜索策略纳入有关VEGFArs699947,rs1570360和rs2010963多态性与肌腱和韧带损伤的关联的文章后,我们评估了它们的质量,并进行了荟萃分析,使用比值比和95%置信区间来检验这些多态性与肌腱和韧带损伤风险之间的联系.
    结果:在86篇相关文章中,6项纳入荟萃分析.其中一些表明VEGFArs2010963与人群中肌腱和韧带损伤的风险之间存在关联。特异性C等位基因是膝关节损伤的不利因素之一。一些研究表明,VEGFArs699947和VEGFArs1570360单核苷酸多态性与前交叉韧带断裂有关。与对照组相比,rs699947CC基因型的个体非接触式前交叉韧带破裂的风险几乎增加了一倍。我们的分析未发现VEGFA基因多态性(rs699947,rs1570360和rs2010963)与肌腱和韧带损伤的机会之间存在任何显着关系,而不考虑种族。然而,欧洲人群表明,VEGFArs699947的CC基因型可导致肌腱和韧带损伤的风险更大,而rs1570360的AG基因型提供了一些保护。此外,rs2010963与肌腱和韧带损伤显着相关;具有C等位基因和CC基因型的个体具有更高的风险。假阳性报告概率证实了我们结果的高度可信度。
    结论:总体而言,本研究未发现VEGFArs699947,rs1570360和rs2010963多态性与肌腱韧带损伤风险之间存在显著关联.然而,在亚组分析中,在欧洲人群中,一些VEGFA基因型rs699947,rs1570360和rs2010963被发现会增加肌腱韧带损伤的风险.
    BACKGROUND: Relevant evidence suggests that angiogenic factors contribute significantly to fibril matrix reconstruction following physical injuries to tendon ligaments. Vascular endothelial growth factor A (VEGFA), with its potent angiogenic effect, has been studied extensively, and its functional polymorphisms, including rs699947, rs1570360, and rs2010963, have been the focus of numerous investigations. Some scholars have explored the association between gene polymorphisms in the VEGFA and the risk of tendon ligament injury, but the findings are not entirely consistent.
    OBJECTIVE: The purpose of this study was to investigate the association between rs699947, rs1570360, and rs2010963 gene polymorphisms in VEGFA and the risk of tendon and ligament injuries.
    METHODS: After including articles about the association of VEGFA rs699947, rs1570360, and rs2010963 polymorphisms with tendon and ligament injuries according to the search strategy, we assessed their quality and conducted meta-analyses to examine the link between these polymorphisms and the risk of tendon and ligament injuries using odds ratios and 95% confidence intervals.
    RESULTS: Of 86 related articles, six were included in the meta-analysis. Some of these suggest an association between VEGFA rs2010963 and the risk of tendon and ligament injury in the population, with the specific C allele being one of the adverse factors for knee injury. Some studies suggest that VEGFA rs699947 and VEGFA rs1570360 single-nucleotide polymorphisms are associated with anterior cruciate ligament rupture. The risk of non-contact anterior cruciate ligament rupture is nearly doubled in individuals with the rs699947 CC genotype compared to the control group. Our analysis did not find any significant relationship between VEGFA gene polymorphisms (rs699947, rs1570360, and rs2010963) and the chance of tendon and ligament injury without consideration of race. However, the European population reveals that the CC genotype of VEGFA rs699947 can result in a greater risk of tendon and ligament injury, whereas the AG genotype for rs1570360 provides some protection. Additionally, rs2010963 was significantly associated with tendon and ligament injury; individuals with the C allele and the CC genotype had higher risk. False-positive report probability confirmed the high credibility of our results.
    CONCLUSIONS: Overall, this study found no significant association between VEGFA rs699947, rs1570360, and rs2010963 polymorphisms and the risk of tendon ligament injury. However, in subgroup analysis, some genotypes of VEGFA rs699947, rs1570360, and rs2010963 were found to increase the risk of tendon ligament injury in European populations.
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  • 文章类型: Journal Article
    目的:探讨肌腱干细胞领域的全球研究现状和研究热点。方法:采用文献计量学方法从WebofScienceCoreCollection(WOSCC)数据库中检索相关数据。此外,城市空间,Vosviewer,SCImago,并利用GraphadPrism分析了该领域的出版状况,确定当前的研究热点,并提交一份小型审查。结果:在该领域最活跃的国家是中国和美国。对这项研究做出重大贡献的著名作者包括LuiPaulinePoYee,唐康来,张建英,尹子,还有陈晓,主要附属于香港医院管理局等机构,第三军医大学,匹兹堡大学,和浙江大学。该领域最常发表的期刊是国际干细胞,骨科研究杂志,干细胞研究和治疗。此外,当前的研究热点主要围绕脚手架,分子机制,和炎症调节。结论:肌腱干细胞作为肌腱组织工程的种子细胞具有重要的潜力,为进一步研究支架提供了有希望的途径。分子机制和炎症调控是目前该领域的研究热点。
    Purpose: This study was aimed to examine the global research status and current research hotspots in the field of tendon stem cells. Methods: Bibliometric methods were employed to retrieve relevant data from the Web of Science Core Collection (WOSCC) database. Additionally, Citespace, Vosviewer, SCImago, and Graphad Prism were utilized to analyze the publication status in this field, identify the current research hotspots, and present a mini-review. Results: The most active countries in this field were China and the United States. Notable authors contributing significantly to this research included Lui Pauline Po Yee, Tang Kanglai, Zhang Jianying, Yin Zi, and Chen Xiao, predominantly affiliated with institutions such as the Hong Kong Hospital Authority, Third Military Medical University, University of Pittsburgh, and Zhejiang University. The most commonly published journals in this field were Stem Cells International, Journal of Orthopedic Research, and Stem Cell Research and Therapy. Moreover, the current research hotspots primarily revolved around scaffolds, molecular mechanisms, and inflammation regulation. Conclusion: Tendon stem cells hold significant potential as seed cells for tendon tissue engineering and offer promising avenues for further research Scaffolds, molecular mechanisms and inflammation regulation are currently research hotspots in this field.
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