Thomopoulos Stavros, Parks William C, Rifkin Daniel B, Derwin Kathleen A
Washington University, Department of Orthopedic Surgery, 660 South Euclid, Campus Box 8233, St. Louis, MO, 63110.
J Orthop Res. 2015 Jun;33(6):832-9. doi: 10.1002/jor.22806. Epub 2015 Mar 2.
Tendon disorders are common and lead to significant disability, pain, healthcare cost, and lost productivity. A wide range of injury mechanisms exist leading to tendinopathy or tendon rupture. Tears can occur in healthy tendons that are acutely overloaded (e.g., during a high speed or high impact event) or lacerated (e.g., a knife injury). Tendinitis or tendinosis can occur in tendons exposed to overuse conditions (e.g., an elite swimmer's training regimen) or intrinsic tissue degeneration (e.g., age-related degeneration). The healing potential of a torn or pathologic tendon varies depending on anatomic location (e.g., Achilles vs. rotator cuff) and local environment (e.g., intrasynovial vs. extrasynovial). Although healing occurs to varying degrees, in general healing of repaired tendons follows the typical wound healing course, including an early inflammatory phase, followed by proliferative and remodeling phases. Numerous treatment approaches have been attempted to improve tendon healing, including growth factor- and cell-based therapies and rehabilitation protocols. This review will describe the current state of knowledge of injury and repair of the three most common tendinopathies--flexor tendon lacerations, Achilles tendon rupture, and rotator cuff disorders--with a particular focus on the use of animal models for understanding tendon healing.
肌腱疾病很常见，会导致严重的残疾、疼痛、医疗费用和生产力损失。导致肌腱病或肌腱断裂的损伤机制多种多样。健康的肌腱在急性过载（例如，在高速或高冲击事件期间）或撕裂（例如，刀伤）时可能会发生撕裂。肌腱炎或肌腱病可能发生在过度使用的肌腱（例如，精英游泳运动员的训练方案）或内在组织退化（例如，与年龄相关的退化）的情况下。撕裂或病理性肌腱的愈合潜力因解剖位置（例如，跟腱与肩袖）和局部环境（例如，滑膜内与滑膜外）而异。尽管愈合程度不同，但一般来说，修复后的肌腱愈合遵循典型的伤口愈合过程，包括早期炎症阶段，随后是增殖和重塑阶段。人们尝试了多种治疗方法来改善肌腱愈合，包括基于生长因子和细胞的疗法以及康复方案。本综述将描述三种最常见的肌腱病——屈肌腱撕裂、跟腱断裂和肩袖疾病——的损伤和修复的当前知识状态，特别关注使用动物模型来理解肌腱愈合。
