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Current Concepts Review   |    
The Role of Mechanical Loading in Tendon Development, Maintenance, Injury, and Repair
Marc T. Galloway, MD1; Andrea L. Lalley, BS2; Jason T. Shearn, PhD2
1 Cincinnati Sports Medicine and Orthopaedic Center, 7423 Mason Montgomery Road, Cincinnati, OH 45249
2 Engineering Research Center, University of Cincinnati, 2901 Woodside Drive, ERC Room 701, Cincinnati, OH 45221. E-mail address for A.L. Lalley: alalley44@gmail.com
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Investigation performed at the Cincinnati Sports Medicine and Orthopaedic Center, and the Engineering Research Center, University of Cincinnati, Cincinnati, Ohio



Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. One or more of the authors, or his or her institution, has had a financial relationship, in the thirty-six months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. No author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2013 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2013 Sep 04;95(17):1620-1628. doi: 10.2106/JBJS.L.01004
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Abstract

➤ Tendon injuries often result from excessive or insufficient mechanical loading, impairing the ability of the local tendon cell population to maintain normal tendon function.

➤ The resident cell population composing tendon tissue is mechanosensitive, given that the cells are able to alter the extracellular matrix in response to modifications of the local loading environment.

➤ Natural tendon healing is insufficient, characterized by improper collagen fibril diameter formation, collagen fibril distribution, and overall fibril misalignment.

➤ Current tendon repair rehabilitation protocols focus on implementing early, well-controlled eccentric loading exercises to improve repair outcome.

➤ Tissue engineers look toward incorporating mechanical loading regimens to precondition cell populations for the creation of improved biological augmentations for tendon repair.

Figures in this Article

    Topics

    tendon ; collagen
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    References

    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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