Spectrum of Tendon Pathologies: Triggers, Trails and End-State.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: The authors declare no conflict of interest. 4. Adv Drug Deliv Rev. 2018 Apr;129:352-375. doi: 10.1016/j.addr.2017.12.016. Epub 2017 Dec 24. Rescue plan for Achilles: Therapeutics steering the fate and functions of stem cells in tendon wound healing. Schneider M(1), Angele P(1), Järvinen TAH(2), Docheva D(3). Author information: (1)Experimental Trauma Surgery, Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany. (2)Faculty of Medicine and Life Sciences & Department of Orthopedics, Unit of Musculoskeletal Surgery, University of Tampere and Tampere University Hospital, Tampere, Finland. (3)Experimental Trauma Surgery, Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany. Electronic address: denitsa.docheva@ukr.de. Due to the increasing age of our society and a rise in engagement of young people in extreme and/or competitive sports, both tendinopathies and tendon ruptures present a clinical and financial challenge. Tendon has limited natural healing capacity and often responds poorly to treatments, hence it requires prolonged rehabilitation in most cases. Till today, none of the therapeutic options has provided successful long-term solutions, meaning that repaired tendons do not recover their complete strength and functionality. Our understanding of tendon biology and healing increases only slowly and the development of new treatment options is insufficient. In this review, following discussion on tendon structure, healing and the clinical relevance of tendon injury, we aim to elucidate the role of stem cells in tendon healing and discuss new possibilities to enhance stem cell treatment of injured tendon. To date, studies mainly apply stem cells, often in combination with scaffolds or growth factors, to surgically created tendon defects. Deeper understanding of how stem cells and vasculature in the healing tendon react to growth factors, common drugs used to treat injured tendons and promising cellular boosters could help to develop new and more efficient ways to manage tendon injuries. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved. DOI: 10.1016/j.addr.2017.12.016