Abstract
The term tendinopathy does not seem more suited to describe the processes that the tendon undergoes during its rearrangement in the case of its biological and structural distress. In effect, the inflammatory process would seem to be absent, or in any case very limited, from a temporal point of view, while it would seem to prevail the biological degeneration process. For this reason, it would seem preferable to use the term “tendinopathy.” In effect, this term would describe much better the profound processes of biological and structural rearrangement that the tendon suffers. However, one cannot ignore the fact that often inflammatory and degenerative processes can coexist.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Notes
- 1.
Pyknosis: in cytology, the contraction of the cell nucleus (pyknotic core) or of all the protoplasm, which looks like a mass intensely colored without regular pattern. It is generally a degeneration sign.
- 2.
The phospholipase A2 are enzymes that have the task to separate the fatty acids from the oxidized phospholipids.
- 3.
Heat shock proteins (HSP) are a class of functionally linked proteins, involved in folding and unfolding of other proteins.
References
Andres BM, Murrell GA (2008) Treatment of tendinopathy: what works, what does not, and what is on the horizon. Clin Orthop Relat Res 466(7):1539–1554
Abate M, Silbernagel KG, Siljeholm C, Di Iorio A, De Amicis D, Salini V, Werner S, Paganelli R (2009) Pathogenesis of tendinopathies: inflammation or degeneration? Arthritis Res Ther 11(3):235
Alfredson H, Ljung BO, Thorsen K, Lorentzon R (2000) In vivo investigation of ECRB tendons with microdialysis technique- no signs of inflammation but high amounts of glutamate in tennis elbow. Acta Orthop Scand 71(5):475–479
Alfredson H, Forsgren S, Thorsen K, Lorentzon R (2001) In vivo microdialysis and immunohistochemical analyses of tendon tissue demonstrated high amounts of free glutamate and glutamate NMDAR1 receptors, but no signs of inflammation, in Jumper’s knee. J Orthop Res 19(5):881–886
Tallon C, Maffulli N, Ewen SW (2001) Ruptured Achilles tendons are significantly more degenerated than tendinopathic tendons. Med Sci Sports Exerc 33(12):1983–1990
Khan KM, Maffulli N, Coleman BD, Cook JL, Taunton JE (1998) Patellar tendinopathy: some aspects of basic science and clinical management. Br J Sports Med 32(4):346–355
Hashimoto T, Nobuhara K, Hamada T (2003) Pathologic evidence of degeneration as a primary cause of rotator cuff tear. Clin Orthop Relat Res 415:111–120
Maffulli N, Wong J, Almekinders LC (2003) Types and epidemiology of tendinopathy. Clin Sports Med 22(4):675–692
Kader D, Saxena A, Movin T, Maffulli N (2002) Achilles tendinopathy: some aspects of basic science and clinical management. Br J Sports Med 36(4):239–249
Józsa L, Kannus P (1997) Human tendon. Anatomy, physiology and pathology. In: Human Kinetics (ed) Champaign.
Paavola M, Kannus P, Järvinen TA, Khan K, Józsa L, Järvinen M (2002) Achilles tendinopathy. J Bone Joint Surg Am 84-A(11):2062–2076
Maffulli N, Sharma P, Luscombe KL (2004) Achilles tendinopathy: aetiology and management. J R Soc Med 97(10):472–476
Backman C, Boquist L, Fridén J, Lorentzon R, Toolanen G (1990) Chronic Achilles paratenonitis with tendinosis: an experimental model in the rabbit. J Orthop Res 8(4):541–547
Archambault JM, Hart DA, Herzog W (2001) Response of rabbit Achilles tendon to chronic repetitive loading. Connect Tissue Res 42(1):13–23
Williams IF, McCullagh KG, Goodship AE, Silver IA (1984) Studies on the pathogenesis of equine tendonitis following collagenase injury. Res Vet Sci 36(3):326–338
Marr CM, McMillan I, Boyd JS, Wright NG, Murray M (1993) Ultrasonographic and histopathological findings in equine superficial digital flexor tendon injury. Equine Vet J 25(1):23–29
Xu Y, Murrell GA (2008) The basic science of tendinopathy. Clin Orthop Relat Res 466(7):1528–1538
Smith MM, Sakurai G, Smith SM, Young AA, Melrose J, Stewart CM, Appleyard RC, Peterson JL, Gillies RM, Dart AJ, Sonnabend DH, Little CB (2008) Modulation of aggrecan and ADAMTS expression in ovine tendinopathy induced by altered strain. Arthritis Rheum 58(4):1055–1066
Yang G, Im HJ, Wang JH (2005) Repetitive mechanical stretching modulates IL-1beta induced COX-2, MMP-1 expression, and PGE2 production in human patellar tendon fibroblasts. Gene 363:166–172
Varga J, Diaz-Perez A, Rosenbloom J, Jimenez SA (1987) PGE2 causes a coordinate decrease in the steady state levels of fibronectin and types I and III procollagen mRNAs in normal human dermal fibroblasts. Biochem Biophys Res Commun 147(3):1282–1288
Riquet FB, Lai WF, Birkhead JR, Suen LF, Karsenty G, Goldring MB (2000) Suppression of type I collagen gene expression by prostaglandins in fibroblasts is mediated at the transcriptional level. Mol Med 6(8):705–719
Thampatty BP, Im HJ, Wang JH (2006) Leukotriene B4 at low dosage negates the catabolic effect of prostaglandin E2 in human patellar tendon fibroblasts. Gene 372:103–109
Cilli F, Khan M, Fu F, Wang JH (2004) Prostaglandin E2 affects proliferation and collagen synthesis by human patellar tendon fibroblasts. Clin J Sport Med 14(4):232–236
Alfredson H, Pietilä T, Jonsson P, Lorentzon R (1998) Heavy-load eccentric calf muscle training for the treatment of chronic Achilles tendinosis. Am J Sports Med 26(3):360–366
Alfredson H, Bjur D, Thorsen K, Lorentzon R, Sandström P (2002) High intratendinous lactate levels in painful chronic Achilles tendinosis. An investigation using microdialysis technique. J Orthop Res 20(5):934–938
Petersen W, Pufe T, Zantop T, Tillmann B, Mentlein R (2003) Hypoxia and PDGF have a synergistic effect that increases the expression of the angiogenetic peptide vascular endothelial growth factor in Achilles tendon fibroblasts. Arch Orthop Trauma Surg 123(9):485–488
Pufe T, Petersen WJ, Mentlein R, Tillmann BN (2005) The role of vasculature and angiogenesis for the pathogenesis of degenerative tendons disease. Scand J Med Sci Sports 15(4):211–222
Sato Y, Abe M, Tanaka K, Iwasaka C, Oda N, Kanno S, Oikawa M, Nakano T, Igarashi T (2000) Signal transduction and transcriptional regulation of angiogenesis. Adv Exp Med Biol 476:109–115
Qi JH, Ebrahem Q, Moore N, Murphy G, Claesson-Welsh L, Bond M, Baker A, Anand-Apte B (2003) A novel function for tissue inhibitor of metalloproteinases-3 (TIMP3): inhibition of angiogenesis by blockage of VEGF binding to VEGF receptor-2. Nat Med 9(4):407–415. Epub 2003 Mar 24
Li Z, Yang G, Khan M, Stone D, Woo SL, Wang JH (2004) Inflammatory response of human tendon fibroblasts to cyclic mechanical stretching. Am J Sports Med 32(2):435–440
Almekinders LC, Banes AJ, Ballenger CA (1993) Effects of repetitive motion on human fibroblasts. Med Sci Sports Exerc 25(5):603–607
Wang JH, Jia F, Yang G, Yang S, Campbell BH, Stone D, Woo SL (2003) Cyclic mechanical stretching of human tendon fibroblasts increases the production of prostaglandin E2 and levels of cyclooxygenase expression: a novel in vitro model study. Connect Tissue Res 44(3-4):128–133
Wang JH, Li Z, Yang G, Khan M (2004) Repetitively stretched tendon fibroblasts produce inflammatory mediators. Clin Orthop Relat Res 422:243–250
Binderman I, Shimshoni Z, Somjen D (1984) Biochemical pathways involved in the translation of physical stimulus into biological message. Calcif Tissue Int 36(Suppl 1):S82–S85
Sumpio BE, Banes AJ, Link GW, Iba T (1990) Modulation of endothelial cell phenotype by cyclic stretch: inhibition of collagen production. J Surg Res 48(5):415–420
Brighton CT, Strafford B, Gross SB, Leatherwood DF, Williams JL, Pollack SR (1991) The proliferative and synthetic response of isolated calvarial bone cells of rats to cyclic biaxial mechanical strain. J Bone Joint Surg Am 73(3):320–331
Banes AJ, Tsuzaki M, Yamamoto J, Fischer T, Brigman B, Brown T, Miller L (1995) Mechanoreception at the cellular level: the detection, interpretation, and diversity of responses to mechanical signals. Biochem Cell Biol 73(7-8):349–365
Birukov KG, Shirinsky VP, Stepanova OV, Tkachuk VA, Hahn AW, Resink TJ, Smirnov VN (1995) Stretch affects phenotype and proliferation of vascular smooth muscle cells. Mol Cell Biochem 144(2):131–139
Matyas JR, Anton MG, Shrive NG, Frank CB (1995) Stress governs tissue phenotype at the femoral insertion of the rabbit MCL. J Biomech 28(2):147–157
Cheng GC, Libby P, Grodzinsky AJ, Lee RT (1996) Induction of DNA synthesis by a single transient mechanical stimulus of human vascular smooth muscle cells. Role of fibroblast growth factor-2. Circulation 93(1):99–105
Brown TD (2000) Techniques for mechanical stimulation of cells in vitro: a review. J Biomech 33(1):3–14
Hsieh AH, Tsai CM, Ma QJ, Lin T, Banes AJ, Villarreal FJ, Akeson WH, Sung KL (2000) Time-dependent increases in type-III collagen gene expression in medical collateral ligament fibroblasts under cyclic strains. J Orthop Res 18(2):220–227
Dike LE, Chen CS, Mrksich M, Tien J, Whitesides GM, Ingber DE (1999) Geometric control of switching between growth, apoptosis, and differentiation during angiogenesis using micropatterned substrates. In Vitro Cell Dev Biol Anim 35(8):441–448
Dirks RC, Warden SJ (2011) Models for the study of tendinopathy. J Musculoskeletal Neuronal Interact 11(2):141–149
Devkota AC, Weinhold PS (2005) A tissue explant system for assessing tendon overuse injury. Med Eng Phys 27(9):803–808
Devkota AC, Tsuzaki M, Almekinders LC, Banes AJ, Weinhold PS (2007) Distributing a fixed amount of cyclic loading to tendon explants over longer periods induces greater cellular and mechanical responses. J Orthop Res 25(8):1078–1086
Lavagnino M, Arnoczky SP, Tian T, Vaupel Z (2003) Effect of amplitude and frequency of cyclic tensile strain on the inhibition of MMP-1 mRNA expression in tendon cells: an in vitro study. Connect Tissue Res 44(3-4):181–187
Provenzano PP, Heisey D, Hayashi K, Lakes R, Vanderby R Jr (2002) Subfailure damage in ligament: a structural and cellular evaluation. J Appl Physiol 92(1):362–371
Wren TA, Lindsey DP, Beaupré GS, Carter DR (2003) Effects of creep and cyclic loading on the mechanical properties and failure of human Achilles tendons. Ann Biomed Eng 31(6):710–717
Majima T, Marchuk LL, Sciore P, Shrive NG, Frank CB, Hart DA (2000) Compressive compared with tensile loading of medial collateral ligament scar in vitro uniquely influences mRNA levels for aggrecan, collagen type II, and collagenase. J Orthop Res 18(4):524–531
Arnoczky SP, Tian T, Lavagnino M, Gardner K (2004) Ex vivo static tensile loading inhibits MMP-1 expression in rat tail tendon cells through a cytoskeletally based mechanotransduction mechanism. J Orthop Res 22(2):328–333
Warden SJ (2007) Animal model for the study of tendinopathy. Br J Sports Med 41(4):232–240
Foland JW, Trotter GW, Powers BE, Wrigley RH, Smith FW (1992) Effect of sodium hyaluronate in collagenase-induced superficial digital flexor tendinitis in horses. Am J Vet Res 53(12):2371–2376
Soslowsky LJ, Carpenter JE, DeBano CM, Banerji I, Moalli MR (1996) Development and use of an animal model for investigations on rotator cuff disease. J Shoulder Elbow Surg 5(5):383–392
Lui PP, Fu SC, Chan LS, Hung LK, Chan KM (2009) Chondrocyte phenotype and ectopic ossification in collagenase-induced tendon degeneration. J Histochem Cytochem 57(2):91–100
Fu SC, Chan KM, Chan LS, Fong DT, Lui PY (2009) The use of motion analysis to measure pain-related behaviour in a rat model of degenerative tendon injuries. J Neurosci Methods 179(2):309–318
Almekinders LC, Temple JD (1998) Etiology, diagnosis, and treatment of tendonitis: an analysis of the literature. Med Sci Sports Exerc 30(8):1183–1190
Stone D, Green C, Rao U, Aizawa H, Yamaji T, Niyibizi C, Carlin G, Woo SL (1999) Cytokine-induced tendinitis: a preliminary study in rabbits. J Orthop Res 17(2):168–177
Langberg H, Skovgaard D, Karamouzis M, Bülow J, Kjaer M (1999) Metabolism and inflammatory mediators in the peritendinous space measured by microdialysis during intermittent isometric exercise in humans. J Physiol 515(Pt 3):919–927
Sullo A, Maffulli N, Capasso G, Testa V (2001) The effects of prolonged peritendinous administration of PGE1 to the rat Achilles tendon: a possible animal model of chronic Achilles tendinopathy. J Orthop Sci 6(4):349–357
Khan MH, Li Z, Wang JH (2005) Repeated exposure of tendon to prostaglandin-E2 leads to localized tendon degeneration. Clin J Sport Med 15(1):27–33
McEwan SR, Davey PG (1988) Ciprofloxacin and tenosynovitis. Lancet 2(8616):900
Rose TF, Bremner DA, Collins J, Ellis-Pegler R, Isaacs R, Richardson R, Small M (1990) Plasma and dialysate levels of pefloxacin and its metabolites in CAPD patients with peritonitis. J Antimicrob Chemother 25(4):657–664
Lee WT, Collins JF (1992) Ciprofloxacin associated bilateral Achilles tendon rupture. Aust N Z J Med 22(5):500
Ribard P, Audisio F, Kahn MF, De Bandt M, Jorgensen C, Hayem G, Meyer O, Palazzo E (1992) Seven Achilles tendinitis including 3 complicated by rupture during fluoroquinolone therapy. J Rheumatol 19(9):1479–1481
Kato M, Takada S, Kashida Y, Nomura M (1995) Histological examination on Achilles tendon lesions induced by quinolone antibacterial agents in juvenile rats. Toxicol Pathol 23(3):385–392
Simonin MA, Gegout-Pottie P, Minn A, Gillet P, Netter P, Terlain B (2000) Pefloxacin-induced achilles tendon toxicity in rodents: biochemical changes in proteoglycan synthesis and oxidative damage to collagen. Antimicrob Agents Chemother 44(4):867–872
Kashida Y, Kato M (1997) Characterization of fluoroquinolone-induced Achilles tendon toxicity in rats: comparison of toxicities of 10 fluoroquinolones and effects of anti-inflammatory compounds. Antimicrob Agents Chemother 41(11):2389–2393
Williams JG (1986) Achilles tendon lesions in sport. Sports Med 3(2):114–135
Khan KM, Maffulli N (1998) Tendinopathy: An Achilles heel for athletes and clinicians. Clin J Sport Med 8(3):151–154
Möller M, Movin T, Granhed H, Lind K, Faxén E, Karlsson J (2001) Acute rupture of tendon Achilles. A prospective randomised study of comparison between surgical and non-surgical treatment. J Bone Joint Surg Br 83:843–848
Paavola M, Kannus P, Järvinen M (2005) Epidemiology of tendon problems in sport. In: Mafulli N, Renström P, Leadbedder W (eds) Tendon injury. Springer-Verlag London Limited, London
Nakama LH, King KB, Abrahamsson S, Rempel DM (2005) Evidence of tendon microtears due to cyclical loading in an in vivo tendinopathy model. J Orthop Res 23(5):1199–1205
Asundi KR, King KB, Rempel DM (2008) Evaluation of gene expression through qRT-PCR in cyclically loaded tendons: an in vivo model. Eur J Appl Physiol 102(3):265–270
Andersson G, Forsgren S, Scott A, Gaida JE, Stjernfeldt JE, Lorentzon R, Alfredson H, Backman C, Danielson P (2011) Tenocyte hypercellularity and vascular proliferation in a rabbit model of tendinopathy: contralateral effects suggest the involvement of central neuronal mechanisms. Br J Sports Med 45(5):399–406
Soslowsky LJ, Thomopoulos S, Tun S, Flanagan CL, Keefer CC, Mastaw J, Carpenter JE (2000) Neer Award 1999. Overuse activity injures the supraspinatus tendon in an animal model: a histologic and biomechanical study. J Shoulder Elbow Surg 9(2):79–84
Perry SM, McIlhenny SE, Hoffman MC, Soslowsky LJ (2005) Inflammatory and angiogenic mRNA levels are altered in a supraspinatus tendon overuse animal model. J Shoulder Elbow Surg 14(1 Suppl S):79S–83S
Millar NL, Wei AQ, Molloy TJ, Bonar F, Murrell GA (2009) Cytokines and apoptosis in supraspinatus tendinopathy. J Bone Joint Surg Br 91(3):417–424
Huang TF, Perry SM, Soslowsky LJ (2004) The effect of overuse activity on Achilles tendon in an animal model: a biomechanical study. Ann Biomed Eng 32(3):336–341
Glazebrook MA, Wright JR Jr, Langman M, Stanish WD, Lee JM (2008) Histological analysis of Achilles tendons in an overuse rat model. J Orthop Res 26(6):840–846
Lindstedt SL, LaStayo PC, Reich TE (2001) When active muscles lengthen: properties and consequences of eccentric contractions. News Physiol Sci 16:256–261
Ljungqvist R (1967) Subcutaneous partial rupture of the Achilles tendon. Acta Orthop Scand Suppl 113:1–5
Fridén J (1984) Muscle soreness after exercise: implications of morphological changes. Int J Sports Med 5(2):57–66
Stauber WT, Clarkson PM, Fritz VK, Evans WJ (1990) Extracellular matrix disruption and pain after eccentric muscle action. J Appl Physiol 69(3):868–874
Sun HB, Li Y, Fung DT, Majeska RJ, Schaffler MB, Flatow EL (2008) Coordinate regulation of IL-1beta and MMP-13 in rat tendons following subrupture fatigue damage. Clin Orthop Relat Res 466(7):1555–1561
Fung DT, Wang VM, Andarawis-Puri N, Basta-Pljakic J, Li Y, Laudier DM, Sun HB, Jepsen KJ, Schaffler MB, Flatow EL (2010) Early response to tendon fatigue damage accumulation in a novel in vivo model. J Biomech 43(2):274–279
Rolf C, Movin T (1997) Etiology, histopathology, and outcome of surgery in achillodynia. Foot Ankle Int 18(9):565–569
Alfredson H, Lorentzon R (2000) Chronic Achilles tendinosis: recommendations for treatment and prevention. Sports Med 29(2):135–146
Nakagawa Y, Totsuka M, Sato T, Fukuda Y, Hirota K (1989) Effect of disuse on the ultrastructure of the Achilles tendon in rats. Eur J Appl Physiol Occup Physiol 59(3):239–242
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2016 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Bisciotti, G.N., Volpi, P. (2016). Tendonitis, Tendinosis, or Tendinopathy?. In: Bisciotti, G., Volpi, P. (eds) The Lower Limb Tendinopathies. Sports and Traumatology. Springer, Cham. https://doi.org/10.1007/978-3-319-33234-5_1
Download citation
DOI: https://doi.org/10.1007/978-3-319-33234-5_1
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-33232-1
Online ISBN: 978-3-319-33234-5
eBook Packages: MedicineMedicine (R0)