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Clerici M, Citro V, Byrne AL, Dale TP, Boccaccini AR, Della Porta G, Maffulli N, Forsyth NR. Endotenon-Derived Type II Tendon Stem Cells Have Enhanced Proliferative and Tenogenic Potential. Int J Mol Sci 2023; 24:15107. [PMID: 37894787 PMCID: PMC10606148 DOI: 10.3390/ijms242015107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 09/08/2023] [Accepted: 10/04/2023] [Indexed: 10/29/2023] Open
Abstract
Tendon injuries caused by overuse or age-related deterioration are frequent. Incomplete knowledge of somatic tendon cell biology and their progenitors has hindered interventions for the effective repair of injured tendons. Here, we sought to compare and contrast distinct tendon-derived cell populations: type I and II tendon stem cells (TSCs) and tenocytes (TNCs). Porcine type I and II TSCs were isolated via the enzymatic digestion of distinct membranes (paratenon and endotenon, respectively), while tenocytes were isolated through an explant method. Resultant cell populations were characterized by morphology, differentiation, molecular, flow cytometry, and immunofluorescence analysis. Cells were isolated, cultured, and evaluated in two alternate oxygen concentrations (physiological (2%) and air (21%)) to determine the role of oxygen in cell biology determination within this relatively avascular tissue. The different cell populations demonstrated distinct proliferative potential, morphology, and transcript levels (both for tenogenic and stem cell markers). In contrast, all tendon-derived cell populations displayed multipotent differentiation potential and immunophenotypes (positive for CD90 and CD44). Type II TSCs emerged as the most promising tendon-derived cell population for expansion, given their enhanced proliferative potential, multipotency, and maintenance of a tenogenic profile at early and late passage. Moreover, in all cases, physoxia promoted the enhanced proliferation and maintenance of a tenogenic profile. These observations help shed light on the biological mechanisms of tendon cells, with the potential to aid in the development of novel therapeutic approaches for tendon disorders.
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Affiliation(s)
- Marta Clerici
- School of Pharmacy and Bioengineering, Keele University, Stoke-on-Trent ST4 7QB, UK; (M.C.); (V.C.); (A.L.B.); (T.P.D.); (N.M.)
- Department of Medicine, Surgery and Dentistry, University of Salerno, Via S. Allende, 84081 Baronissi, Italy;
| | - Vera Citro
- School of Pharmacy and Bioengineering, Keele University, Stoke-on-Trent ST4 7QB, UK; (M.C.); (V.C.); (A.L.B.); (T.P.D.); (N.M.)
- Institute for Biomaterials, Department of Materials Science and Engineering, Friedrich-Alexander-University of Erlangen-Nürnberg, 91058 Erlangen, Germany;
| | - Amy L. Byrne
- School of Pharmacy and Bioengineering, Keele University, Stoke-on-Trent ST4 7QB, UK; (M.C.); (V.C.); (A.L.B.); (T.P.D.); (N.M.)
| | - Tina P. Dale
- School of Pharmacy and Bioengineering, Keele University, Stoke-on-Trent ST4 7QB, UK; (M.C.); (V.C.); (A.L.B.); (T.P.D.); (N.M.)
| | - Aldo R. Boccaccini
- Institute for Biomaterials, Department of Materials Science and Engineering, Friedrich-Alexander-University of Erlangen-Nürnberg, 91058 Erlangen, Germany;
| | - Giovanna Della Porta
- Department of Medicine, Surgery and Dentistry, University of Salerno, Via S. Allende, 84081 Baronissi, Italy;
- Interdepartmental Centre BIONAM, University of Salerno, Via Giovanni Paolo I, 84084 Fisciano, Italy
| | - Nicola Maffulli
- School of Pharmacy and Bioengineering, Keele University, Stoke-on-Trent ST4 7QB, UK; (M.C.); (V.C.); (A.L.B.); (T.P.D.); (N.M.)
- Department of Medicine, Surgery and Dentistry, University of Salerno, Via S. Allende, 84081 Baronissi, Italy;
- Department of Trauma and Orthopaedic Surgery, University Hospital “San Giovanni di Dio e Ruggi D’Aragona”, 84131 Salerno, Italy
- Department of Trauma and Orthopaedics, Faculty of Medicine and Psychology, Sant’Andrea Hospital, Sapienza University, 00189 Rome, Italy
| | - Nicholas R. Forsyth
- School of Pharmacy and Bioengineering, Keele University, Stoke-on-Trent ST4 7QB, UK; (M.C.); (V.C.); (A.L.B.); (T.P.D.); (N.M.)
- Vice Principals’ Office, University of Aberdeen, Kings College, Aberdeen AB24 3FX, UK
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Ren X, Zhuang H, Zhang Y, Zhou P. Cerium oxide nanoparticles-carrying human umbilical cord mesenchymal stem cells counteract oxidative damage and facilitate tendon regeneration. J Nanobiotechnology 2023; 21:359. [PMID: 37789395 PMCID: PMC10546722 DOI: 10.1186/s12951-023-02125-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 09/21/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND Tendon injuries have a high incidence and limited treatment options. Stem cell transplantation is essential for several medical conditions like tendon injuries. However, high local concentrations of reactive oxygen species (ROS) inhibit the activity of transplanted stem cells and hinder tendon repair. Cerium oxide nanoparticles (CeONPs) have emerged as antioxidant agents with reproducible reducibility. RESULTS In this study, we synthesized polyethylene glycol-packed CeONPs (PEG-CeONPs), which were loaded into the human umbilical cord mesenchymal stem cells (hUCMSCs) to counteract oxidative damage. H2O2 treatment was performed to evaluate the ROS scavenging ability of PEG-CeONPs in hUCMSCs. A rat model of patellar tendon defect was established to assess the effect of PEG-CeONPs-carrying hUCMSCs in vivo. The results showed that PEG-CeONPs exhibited excellent antioxidant activity both inside and outside the hUCMSCs. PEG-CeONPs protect hUCMSCs from senescence and apoptosis under excessive oxidative stress. Transplantation of hUCMSCs loaded with PEG-CeONPs reduced ROS levels in the tendon injury area and facilitated tendon healing. Mechanistically, NFκB activator tumor necrosis factor α and MAPK activator dehydrocrenatine, reversed the therapeutic effect of PEG-CeONPs in hUCMSCs, indicating that PEG-CeONPs act by inhibiting the NFκB and MAPK signaling pathways. CONCLUSIONS The carriage of the metal antioxidant oxidase PEG-CeONPs maintained the ability of hUCMSCs in the injured area, reduced the ROS levels in the microenvironment, and facilitated tendon regeneration. The data presented herein provide a novel therapeutic strategy for tendon healing and new insights into the use of stem cells for disease treatment.
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Affiliation(s)
- Xunshan Ren
- Department of Orthopedics, Renmin Hospital of Wuhan University, Wuhan, China
| | - Huangming Zhuang
- Department of Orthopedics, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yuelong Zhang
- Department of Orthopedics, Renmin Hospital of Wuhan University, Wuhan, China
| | - Panghu Zhou
- Department of Orthopedics, Renmin Hospital of Wuhan University, Wuhan, China.
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3
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Holt NC, Mayfield DL. Muscle-tendon unit design and tuning for power enhancement, power attenuation, and reduction of metabolic cost. J Biomech 2023; 153:111585. [PMID: 37126884 PMCID: PMC10949972 DOI: 10.1016/j.jbiomech.2023.111585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 04/06/2023] [Indexed: 05/03/2023]
Abstract
The contractile elements in skeletal muscle fibers operate in series with elastic elements, tendons and potentially aponeuroses, in muscle-tendon units (MTUs). Elastic strain energy (ESE), arising from either work done by muscle fibers or the energy of the body, can be stored in these series elastic elements (SEEs). MTUs vary considerably in their design in terms of the relative lengths and stiffnesses of the muscle fibers and SEEs, and the force and work generating capacities of the muscle fibers. However, within an MTU it is thought that contractile and series elastic elements can be matched or tuned to maximize ESE storage. The use of ESE is thought to improve locomotor performance by enhancing contractile element power during activities such as jumping, attenuating contractile element power during activities such as landing, and reducing the metabolic cost of movement during steady-state activities such as walking and running. The effectiveness of MTUs in these potential roles is contingent on factors such as the source of mechanical energy, the control of the flow of energy, and characteristics of SEE recoil. Hence, we suggest that MTUs specialized for ESE storage may vary considerably in the structural, mechanical, and physiological properties of their components depending on their functional role and required versatility.
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Affiliation(s)
- N C Holt
- Department of Evolution, Ecology and Organismal Biology, University of California Riverside, 900 University Avenue, Riverside, CA 92521, USA.
| | - D L Mayfield
- Department of Evolution, Ecology and Organismal Biology, University of California Riverside, 900 University Avenue, Riverside, CA 92521, USA
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Aletto C, Aicale R, Oliva F, Maffulli N. Hand Flexor Tendon Repair: From Biology to Surgery and Rehabilitation. Hand Clin 2023; 39:215-225. [PMID: 37080653 DOI: 10.1016/j.hcl.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
Tendon biology and anatomy are crucial to manage hand flexor tendon injuries, not only for surgical treatment but also for rehabilitation; surgeon and physical therapist have to choose zone by zone the best way to manage and restore the normal function of hand flexor tendons.
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Affiliation(s)
- Cristian Aletto
- Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, Baronissi 84084, Italy; Clinica Ortopedica, Ospedale San Giovanni di Dio e Ruggi D'Aragona, Salerno 84131, Italy.
| | - Rocco Aicale
- Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, Baronissi 84084, Italy; Clinica Ortopedica, Ospedale San Giovanni di Dio e Ruggi D'Aragona, Salerno 84131, Italy
| | - Francesco Oliva
- Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, Baronissi 84084, Italy; Clinica Ortopedica, Ospedale San Giovanni di Dio e Ruggi D'Aragona, Salerno 84131, Italy
| | - Nicola Maffulli
- Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, Baronissi 84084, Italy; Clinica Ortopedica, Ospedale San Giovanni di Dio e Ruggi D'Aragona, Salerno 84131, Italy; Queen Mary University of London, Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Mile End Hospital, 275 Bancroft Road, London E1 4DG, England; Keele University, Faculty of Medicine, School of Pharmacy and Bioengineering, Guy Hilton Research Centre, Thornburrow Drive, Hartshill, Stoke-on-Trent ST4 7QB, UK
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5
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Ding L, Zhou B, Hou Y, Xu L. Stem cells in tendon regeneration and factors governing tenogenesis. Curr Stem Cell Res Ther 2022; 17:503-512. [PMID: 35086458 DOI: 10.2174/1574888x17666220127111135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 11/16/2021] [Accepted: 12/08/2021] [Indexed: 11/22/2022]
Abstract
Tendons are connective tissue structures of paramount importance to the human ability of locomotion. Tendinopathy and tendon rupture can be resistant to treatment and often recurs, thus resulting in a significant health problem with a relevant social impact worldwide. Unfortunately, existing treatment approaches are suboptimal. A better understanding of the basic biology of tendons may provide a better way to solve these problems and promote tendon regeneration. Stem cells, either obtained from tendons or non-tendon sources, such as bone marrow (BMSCs), adipose tissue (AMSCs), as well as embryonic stem cells (ESCs) and induced pluripotent stem cells (iPSCs), have received increasing attention toward enhancing tendon healing. There are many studies showing that stem cells can contribute to improving tendon healing. Hence, in this review, the current knowledge of BMSCs, AMSCs, TSPCs, ESCs and iPSCs for tendon regeneration, as well as the advantages and limitations among them, has been highlighted. Moreover, the transcriptional and bioactive factors governing tendon healing processes have been discussed.
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Affiliation(s)
- Lingli Ding
- Lingnan Medical Research Center, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - BingYu Zhou
- Lingnan Medical Research Center, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yonghui Hou
- Key Laboratory of Orthopaedics & Traumatology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, PR China
| | - Liangliang Xu
- Lingnan Medical Research Center, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
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6
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Van Gulick L, Saby C, Jaisson S, Okwieka A, Gillery P, Dervin E, Morjani H, Beljebbar A. An integrated approach to investigate age-related modifications of morphological, mechanical and structural properties of type I collagen. Acta Biomater 2022; 137:64-78. [PMID: 34673231 DOI: 10.1016/j.actbio.2021.10.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 10/08/2021] [Accepted: 10/12/2021] [Indexed: 11/24/2022]
Abstract
The main propose of this study is to characterize the impact of chronological aging on mechanical, structural, biochemical, and morphological properties of type I collagen. We have developed an original approach combining a stress-strain measurement device with a portable Raman spectrometer to enable simultaneous measurement of Raman spectra during stress vs strain responses of young adult, adult and old rat tail tendon fascicles (RTTFs). Our data showed an increase in all mechanical properties such as Young's modulus, yield strength, and ultimate tensile strength with aging. At the molecular level, Raman data revealed that the most relevant frequency shift was observed at 938 cm-1 in Old RTTFs, which is assigned to the C-C. This suggested a long axis deformation of the peptide chains in Old RTTFs during tensile stress. In addition, the intensity of the band at 872 cm-1, corresponding to hydroxyproline decreased for young adult RTTFs and increased for the adult ones, while it remained unchanged for Old RTTFs during tensile stress. The amide III band (1242 and 1265 cm-1) as well as the band ratios I1631/ I1663 and I1645 / I1663 responses to tensile stress were depending on mechanical phases (toe, elastic and plastic). The quantification of advanced glycation end-products by LC-MS/MS and spectrofluorometry showed an increase in their content with aging. This suggested that the accumulation of such products was correlated to the alterations observed in the mechanical and molecular properties of RTTFs. Analysis of the morphological properties of RTTFs by SHG combined with CT-FIRE software revealed an increase in length and straightness of collagen fibers, whereas their width and wavy fraction decreased. Our integrated study model could be useful to provide additional translational information to monitor progression of diseases related to collagen remodeling in musculoskeletal disorders. STATEMENT OF SIGNIFICANCE: Type I collagen is the major component of the extracellular matrix. Its architectural and structural organization plays an important role in the mechanical properties of many tissues at the physiological and pathological levels. The objective of this work is to develop an integrated approach to bring a new insight on the impact of chronological aging on the structural organization and mechanical properties of type I collagen. We combined a portable Raman spectrometer with a mechanical tensile testing device in order to monitor in real time the changes in the Raman fingerprint of type I collagen fibers during the mechanical stress. Raman spectroscopy allowed the identification of the type I collagen bonds that were affected by mechanical stress in a differential manner with aging.
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7
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Atta G, Tempfer H, Kaser-Eichberger A, Traweger A, Heindl LM, Schroedl F. Is the human sclera a tendon-like tissue? A structural and functional comparison. Ann Anat 2021; 240:151858. [PMID: 34798297 DOI: 10.1016/j.aanat.2021.151858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 09/22/2021] [Accepted: 11/09/2021] [Indexed: 12/17/2022]
Abstract
Collagen rich connective tissues fulfill a variety of important functions throughout the human body, most of which having to resist mechanical challenges. This review aims to compare structural and functional aspects of tendons and sclera, two tissues with distinct location and function, but with striking similarities regarding their cellular content, their extracellular matrix and their low degree of vascularization. The description of these similarities meant to provide potential novel insight for both the fields of orthopedic research and ophthalmology.
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Affiliation(s)
- Ghada Atta
- Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; Institute for Tendon and Bone Regeneration, Spinal Cord Injury and Tissue Regeneration Center Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Herbert Tempfer
- Institute for Tendon and Bone Regeneration, Spinal Cord Injury and Tissue Regeneration Center Salzburg, Paracelsus Medical University, Salzburg, Austria; Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Alexandra Kaser-Eichberger
- Center for Anatomy and Cell Biology, Institute of Anatomy and Cell Biology - Salzburg, Paracelsus Medical University, Strubergasse 21, 5020 Salzburg, Austria
| | - Andreas Traweger
- Institute for Tendon and Bone Regeneration, Spinal Cord Injury and Tissue Regeneration Center Salzburg, Paracelsus Medical University, Salzburg, Austria; Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Ludwig M Heindl
- Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; Center for Integrated Oncology (CIO) Aachen - Bonn - Cologne - Düsseldorf, Cologne, Germany
| | - Falk Schroedl
- Center for Anatomy and Cell Biology, Institute of Anatomy and Cell Biology - Salzburg, Paracelsus Medical University, Strubergasse 21, 5020 Salzburg, Austria.
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8
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Zhou S, Yuan B, Huang W, Tang Y, Chen X. Preparation and biological characteristics of a bovine acellular tendon fiber material. J Biomed Mater Res A 2021; 109:1931-1941. [PMID: 33811434 DOI: 10.1002/jbm.a.37185] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 03/14/2021] [Accepted: 03/24/2021] [Indexed: 11/07/2022]
Abstract
Acellular tendon matrix is an ideal substitute for constructing tissue engineering ligaments, but using detergents causes damage to collagen and fibrin during the process of decellularization. In this study, fresh tendons were lyophilized and separated into fresh tendon fiber (FTF) bundles, and then the cellular components in FTF were removed to prepare acellular tendon fiber (ATF) without adding chemical detergent. H&E staining and DAPI fluorescence microscopy showed no nucleus and DNA residue. Compared with FTFs, the DNA content of ATFs was significantly lower without the collagen content change before and after decellularization. The microstructure of collagen fibrils in ATFs was intact under scanning electron microscopy (SEM), and the maximum tensile load and elastic modulus between FTFs and ATFs were not statistically different. The ATF bundles were cultured with SD rat tenocytes for 72 hr and cells attachment to fiber surfaces were observed under SEM. ATF bundles were then implanted into paraspinal muscles, and histological analysis showed fibroblast-like cells within the ATFs and was similar to the control group (fresh tendon autograft) in morphology. H&E staining showed that the number of lymphocytes and plasma cells in ATF was less than that in fresh tendon autograft. ATF bundles were twisted into linear fiber materials by hand, of which the maximum breaking strength was similar to silk with same diameter. These findings demonstrated that ATFs retain their original fibril structure and mechanical properties after decellularization by trypsin and pancreatic deoxyribonuclease without detergent. Lyophilized ATFs linear fiber material provides the possibility of preparing personalized ligament and other tissue engineering scaffolds.
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Affiliation(s)
- Shengyuan Zhou
- Spine Center, Department of Orthopedic Surgery, Chang Zheng Hospital, Naval Medical Univeristy (Second Military Medical University), Shanghai, China
| | - Bo Yuan
- Spine Center, Department of Orthopedic Surgery, Chang Zheng Hospital, Naval Medical Univeristy (Second Military Medical University), Shanghai, China
| | - Wenmao Huang
- Spine Center, Department of Orthopedic Surgery, Chang Zheng Hospital, Naval Medical Univeristy (Second Military Medical University), Shanghai, China
| | - Yifan Tang
- Spine Center, Department of Orthopedic Surgery, Chang Zheng Hospital, Naval Medical Univeristy (Second Military Medical University), Shanghai, China
| | - Xiongsheng Chen
- Spine Center, Department of Orthopedic Surgery, Chang Zheng Hospital, Naval Medical Univeristy (Second Military Medical University), Shanghai, China
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Hou J, Yang R, Vuong I, Li F, Kong J, Mao HQ. Biomaterials strategies to balance inflammation and tenogenesis for tendon repair. Acta Biomater 2021; 130:1-16. [PMID: 34082095 DOI: 10.1016/j.actbio.2021.05.043] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 05/15/2021] [Accepted: 05/24/2021] [Indexed: 12/17/2022]
Abstract
Adult tendon tissue demonstrates a limited regenerative capacity, and the natural repair process leaves fibrotic scar tissue with inferior mechanical properties. Surgical treatment is insufficient to provide the mechanical, structural, and biochemical environment necessary to restore functional tissue. While numerous strategies including biodegradable scaffolds, bioactive factor delivery, and cell-based therapies have been investigated, most studies have focused exclusively on either suppressing inflammation or promoting tenogenesis, which includes tenocyte proliferation, ECM production, and tissue formation. New biomaterials-based approaches represent an opportunity to more effectively balance the two processes and improve regenerative outcomes from tendon injuries. Biomaterials applications that have been explored for tendon regeneration include formation of biodegradable scaffolds presenting topographical, mechanical, and/or immunomodulatory cues conducive to tendon repair; delivery of immunomodulatory or tenogenic biomolecules; and delivery of therapeutic cells such as tenocytes and stem cells. In this review, we provide the biological context for the challenges in tendon repair, discuss biomaterials approaches to modulate the immune and regenerative environment during the healing process, and consider the future development of comprehensive biomaterials-based strategies that can better restore the function of injured tendon. STATEMENT OF SIGNIFICANCE: Current strategies for tendon repair focus on suppressing inflammation or enhancing tenogenesis. Evidence indicates that regulated inflammation is beneficial to tendon healing and that excessive tissue remodeling can cause fibrosis. Thus, it is necessary to adopt an approach that balances the benefits of regulated inflammation and tenogenesis. By reviewing potential treatments involving biodegradable scaffolds, biological cues, and therapeutic cells, we contrast how each strategy promotes or suppresses specific repair steps to improve the healing outcome, and highlight the advantages of a comprehensive approach that facilitates the clearance of necrotic tissue and recruitment of cells during the inflammatory stage, followed by ECM synthesis and organization in the proliferative and remodeling stages with the goal of restoring function to the tendon.
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10
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Abstract
Flexor tendon injuries are common and occur mostly by penetrating trauma. Suspected flexor tendon injuries require a thorough clinical assessment and often are not isolated injuries. A detailed understanding of flexor tendon anatomy and spatial relationships is essential, especially when repairing multi-tendon injuries. Principles of flexor tendon repair include a strong suture construct, minimising gap formation between tendon ends, preserving tendon blood supply and providing a smooth repair interface. Moreover, adequate exposure of the zone of injury using full-thickness skin flaps and preservation of neurovascular and pulley structures is essential. In this article an overview of contemporary management strategies is presented. Today's hand surgeons and therapists can choose from a variety of treatment options when managing these important and potentially life-changing injuries.
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Affiliation(s)
- Oliver Pearce
- Trauma Registrar, Trauma & Orthopaedic Department, Southmead Hospital, Southmead Road, Bristol BS10 5NB, UK
| | - Matthew T Brown
- Fellow in Hand & Wrist Surgery, Lothian Hand Unit, St John's Hospital, Livingston, West Lothian EH54 6PP, UK
| | - Katrina Fraser
- Clinical Specialist Occupational Therapist (Hand Therapy), Lothian Hand Unit, St John's Hospital, Livingston, West Lothian EH54 6PP, UK
| | - Luca Lancerotto
- Consultant Hand & Plastic Surgeon, Lothian Hand Unit, St John's Hospital, Livingston, West Lothian EH54 6PP, UK
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11
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Li Y, Wu T, Liu S. Identification and Distinction of Tenocytes and Tendon-Derived Stem Cells. Front Cell Dev Biol 2021; 9:629515. [PMID: 33937230 PMCID: PMC8085586 DOI: 10.3389/fcell.2021.629515] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 03/29/2021] [Indexed: 01/01/2023] Open
Abstract
Restoring the normal structure and function of injured tendons is one of the biggest challenges in orthopedics and sports medicine department. The discovery of tendon-derived stem cells (TDSCs) provides a novel perspective to treat tendon injuries, which is expected to be an ideal seed cell to promote tendon repair and regeneration. Because of the lack of specific markers, the identification of tenocytes and TDSCs has not been conclusive in the in vitro study of tendons. In addition, the morphology of tendon derived cells is similar, and the comparison and identification of tenocytes and TDSCs are insufficient, which causes some obstacles to the in vitro study of tendon. In this review, the characteristics of tenocytes and TDSCs are summarized and compared based on some existing research results (mainly in terms of biomarkers), and a potential marker selection for identification is suggested. It is of profound significance to further explore the mechanism of biomarkers in vivo and to find more specific markers.
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Affiliation(s)
- Yuange Li
- Department of Orthopaedics, Shanghai Sixth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Tianyi Wu
- Department of Orthopaedics, Shanghai Sixth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Shen Liu
- Department of Orthopaedics, Shanghai Sixth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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12
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Wang D, Zhang X, Huang S, Liu Y, Fu BSC, Mak KKL, Blocki AM, Yung PSH, Tuan RS, Ker DFE. Engineering multi-tissue units for regenerative Medicine: Bone-tendon-muscle units of the rotator cuff. Biomaterials 2021; 272:120789. [PMID: 33845368 DOI: 10.1016/j.biomaterials.2021.120789] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 03/25/2021] [Accepted: 03/26/2021] [Indexed: 12/13/2022]
Abstract
Our body systems are comprised of numerous multi-tissue units. For the musculoskeletal system, one of the predominant functional units is comprised of bone, tendon/ligament, and muscle tissues working in tandem to facilitate locomotion. To successfully treat musculoskeletal injuries and diseases, critical consideration and thoughtful integration of clinical, biological, and engineering aspects are necessary to achieve translational bench-to-bedside research. In particular, identifying ideal biomaterial design specifications, understanding prior and recent tissue engineering advances, and judicious application of biomaterial and fabrication technologies will be crucial for addressing current clinical challenges in engineering multi-tissue units. Using rotator cuff tears as an example, insights relevant for engineering a bone-tendon-muscle multi-tissue unit are presented. This review highlights the tissue engineering strategies for musculoskeletal repair and regeneration with implications for other bone-tendon-muscle units, their derivatives, and analogous non-musculoskeletal tissue structures.
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Affiliation(s)
- Dan Wang
- Institute for Tissue Engineering and Regenerative Medicine, The Chinese University of Hong Kong, Hong Kong SAR; School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong SAR; Ministry of Education Key Laboratory for Regenerative Medicine, School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong SAR; Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong SAR
| | - Xu Zhang
- Institute for Tissue Engineering and Regenerative Medicine, The Chinese University of Hong Kong, Hong Kong SAR; School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong SAR
| | - Shuting Huang
- Institute for Tissue Engineering and Regenerative Medicine, The Chinese University of Hong Kong, Hong Kong SAR; School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong SAR
| | - Yang Liu
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong SAR
| | - Bruma Sai-Chuen Fu
- Institute for Tissue Engineering and Regenerative Medicine, The Chinese University of Hong Kong, Hong Kong SAR; Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong SAR
| | | | - Anna Maria Blocki
- Institute for Tissue Engineering and Regenerative Medicine, The Chinese University of Hong Kong, Hong Kong SAR; School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong SAR; Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong SAR
| | - Patrick Shu-Hang Yung
- Institute for Tissue Engineering and Regenerative Medicine, The Chinese University of Hong Kong, Hong Kong SAR; Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong SAR
| | - Rocky S Tuan
- Institute for Tissue Engineering and Regenerative Medicine, The Chinese University of Hong Kong, Hong Kong SAR; School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong SAR
| | - Dai Fei Elmer Ker
- Institute for Tissue Engineering and Regenerative Medicine, The Chinese University of Hong Kong, Hong Kong SAR; School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong SAR; Ministry of Education Key Laboratory for Regenerative Medicine, School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong SAR; Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong SAR.
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13
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Nakamichi R, Asahara H. Regulation of tendon and ligament differentiation. Bone 2021; 143:115609. [PMID: 32829041 PMCID: PMC7770025 DOI: 10.1016/j.bone.2020.115609] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/06/2020] [Accepted: 08/17/2020] [Indexed: 02/08/2023]
Abstract
Tendons transmit power from muscles to bones, and ligaments maintain the stability of joints, thus producing smooth and flexible movements of articular joints. However, tendons have poor self-healing ability upon damage due to injuries, diseases, or aging. To maintain homeostasis or promote regeneration of the tendon/ligament, it is critical to understand the mechanism responsible for the coordination of tendon/ligament-specific gene expression and subsequent cell differentiation. In this review, we have discussed the core molecular mechanisms involved in the development and homeostasis of tendons and ligaments, with particular focus on transcription factors, signaling, and mechanical stress.
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Affiliation(s)
- Ryo Nakamichi
- Department of Molecular Medicine, The Scripps Research Institute, 10550 North Torrey Pines Road, MBB-102, , La Jolla, CA 92037, USA; Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
| | - Hiroshi Asahara
- Department of Molecular Medicine, The Scripps Research Institute, 10550 North Torrey Pines Road, MBB-102, , La Jolla, CA 92037, USA; Department of Systems Biomedicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan.
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14
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Pugliese BR, Brisbois AL, Size KJ, St George LB, Hobbs SJ, Kirker-Head CA. Biomechanical and wearability testing of novel legwear for variably limiting extension of the metacarpophalangeal joint of horses. Am J Vet Res 2020; 82:39-47. [PMID: 33369493 DOI: 10.2460/ajvr.82.1.39] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the ability of novel legwear designed to limit extension of the metacarpophalangeal joint (MCPJ) to redirect loading forces from the flexor apparatus during walk, trot, and canter on a treadmill and during unrestrained and restrained activity in a stall. ANIMALS 6 adult horses without musculoskeletal disease. PROCEDURES Legwear-derived force data were recorded under 4 conditions: inactive state (unlimited legwear extension) and 3 active (restrictive) states (mild, 30° extension; moderate, 20° extension; or maximum, 10° extension). Associations between peak legwear loads and torques among legwear states and treadmill gaits and stall activities were assessed. The hair coat and skin of the forelimbs were examined for any legwear-induced adverse effects after testing. RESULTS During the treadmill exercises, moderate restriction of legwear extension resulted in significantly higher peak load and torque than mild restriction, and faster speeds (canter vs walk or trot and trot vs walk) yielded significantly higher peak load and torque. During in-stall activity, maximum restriction of legwear extension yielded significantly higher peak load and torque than moderate restriction. Unrestrained in-stall activity resulted in significantly higher peak load and torque than restrained activity. The legwear caused minimal adverse effects on the hair coat and skin of the forelimbs. CONCLUSIONS AND CLINICAL RELEVANCE Findings suggested that the legwear variably reduced peak loads on the flexor apparatus. Extension of the MCPJ may be incrementally adjusted through the legwear such that return to activity may be controlled, and controlled return to activity is crucial for rehabilitating flexor apparatus injuries.
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15
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Malladi S, Miranda-Nieves D, Leng L, Grainger SJ, Tarabanis C, Nesmith AP, Kosaraju R, Haller CA, Parker KK, Chaikof EL, Günther A. Continuous Formation of Ultrathin, Strong Collagen Sheets with Tunable Anisotropy and Compaction. ACS Biomater Sci Eng 2020; 6:4236-4246. [PMID: 32685675 PMCID: PMC7362332 DOI: 10.1021/acsbiomaterials.0c00321] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 05/26/2020] [Indexed: 01/08/2023]
Abstract
The multiscale organization of protein-based fibrillar materials is a hallmark of many organs, but the recapitulation of hierarchal structures down to fibrillar scales, which is a requirement for withstanding physiological loading forces, has been challenging. We present a microfluidic strategy for the continuous, large-scale formation of strong, handleable, free-standing, multicentimeter-wide collagen sheets of unprecedented thinness through the application of hydrodynamic focusing with the simultaneous imposition of strain. Sheets as thin as 1.9 μm displayed tensile strengths of 0.5-2.7 MPa, Young's moduli of 3-36 MPa, and modulated the diffusion of molecules as a function of collagen nanoscale structure. Smooth muscle cells cultured on engineered sheets oriented in the direction of aligned collagen fibrils and generated coordinated vasomotor responses. The described biofabrication approach enables rapid formation of ultrathin collagen sheets that withstand physiologically relevant loads for applications in tissue engineering and regenerative medicine, as well as in organ-on-chip and biohybrid devices.
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Affiliation(s)
- Shashi Malladi
- Department
of Mechanical and Industrial Engineering, University of Toronto, Toronto, Ontario M5S3G8, Canada
| | - David Miranda-Nieves
- Division
of Health Sciences and Technology, Massachusetts
Institute of Technology, Cambridge, Massachusetts 02139, United States
- Department
of Surgery, Beth Israel Deaconess Medical
Center, Boston, Massachusetts 02115, United States
- Wyss
Institute for Biologically Inspired Engineering of Harvard University, Harvard University, Cambridge, Massachusetts 02138, United States
| | - Lian Leng
- Department
of Mechanical and Industrial Engineering, University of Toronto, Toronto, Ontario M5S3G8, Canada
| | - Stephanie J. Grainger
- Department
of Surgery, Beth Israel Deaconess Medical
Center, Boston, Massachusetts 02115, United States
| | - Constantine Tarabanis
- Department
of Surgery, Beth Israel Deaconess Medical
Center, Boston, Massachusetts 02115, United States
| | - Alexander P. Nesmith
- Wyss
Institute for Biologically Inspired Engineering of Harvard University, Harvard University, Cambridge, Massachusetts 02138, United States
| | - Revanth Kosaraju
- Department
of Surgery, Beth Israel Deaconess Medical
Center, Boston, Massachusetts 02115, United States
| | - Carolyn A. Haller
- Department
of Surgery, Beth Israel Deaconess Medical
Center, Boston, Massachusetts 02115, United States
| | - Kevin Kit Parker
- Wyss
Institute for Biologically Inspired Engineering of Harvard University, Harvard University, Cambridge, Massachusetts 02138, United States
| | - Elliot L. Chaikof
- Division
of Health Sciences and Technology, Massachusetts
Institute of Technology, Cambridge, Massachusetts 02139, United States
- Department
of Surgery, Beth Israel Deaconess Medical
Center, Boston, Massachusetts 02115, United States
- Wyss
Institute for Biologically Inspired Engineering of Harvard University, Harvard University, Cambridge, Massachusetts 02138, United States
| | - Axel Günther
- Department
of Mechanical and Industrial Engineering, University of Toronto, Toronto, Ontario M5S3G8, Canada
- Institute
of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario M5S 3G9, Canada
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16
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Xu C, Wang Y, He J, Pan D, Wang H, Zhou G, Cao J. The comparative research of structural and textural characteristics of six kinds of collagen-based sauce braised meat products. J Food Sci 2020; 85:1675-1680. [PMID: 32469102 DOI: 10.1111/1750-3841.15119] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 02/27/2020] [Accepted: 03/01/2020] [Indexed: 11/27/2022]
Abstract
Collagen-based sauce braised meat products with a unique flavor, chewiness, and springiness are very popular in China. In order to understand how the structure, thermal properties, and chemical components of collagen-based tissues influence the texture characteristics of collagen-based meat products during stewing, three kinds of tendon tissues (chicken feet tendon [CFT], sheep tendon [ST], and bovine tendon [BT]) and three kinds of skin tissues (chicken feet skin [CFS], sheep skin [SS], and porcine skin [PS]) were selected to heat for 45 min at 95 °C, and texture, thermal properties, micromorphology, ultrastructure, glycosaminoglycan (GAG) content, and collagen content were evaluated among the six kinds of collagen-based tissues. Results showed that BT had the highest hardness, chewiness values, total collagen content, and the thickest fibers diameters, followed by ST, CFT, PS, and SS, whereas CFS had lowest values among six kinds of tissues. The thermal stability and GAG levels in tendon samples were higher than those in skin samples. Thicker diameters, higher thermal stability, GAG, and total collagen content could be responsible for the higher hardness and chewiness of tendon samples compared with skin tissues. These findings provide the understanding of relationship between meat quality of collagen-based meat products and their morphological and chemical properties. PRACTICAL APPLICATION: This research confirms that the difference in texture of different kinds of collagen-based tissues was related to the difference in structure and chemical properties. The result can be used to optimize the processing conditions of collagen-based sauce braised meat products in food industry.
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Affiliation(s)
- Chunyan Xu
- State Key Laboratory for Managing Biotic and Chemical Threats to the Quality and Safety of Agro-products, Ningbo University, Ningbo, 315211, China.,Key Laboratory of Animal Protein Food Processing Technology of Zhejiang Province, Ningbo University, Ningbo, 315211, China
| | - Ying Wang
- Key Laboratory of Animal Protein Food Processing Technology of Zhejiang Province, Ningbo University, Ningbo, 315211, China
| | - Jun He
- Key Laboratory of Animal Protein Food Processing Technology of Zhejiang Province, Ningbo University, Ningbo, 315211, China
| | - Daodong Pan
- State Key Laboratory for Managing Biotic and Chemical Threats to the Quality and Safety of Agro-products, Ningbo University, Ningbo, 315211, China.,Key Laboratory of Animal Protein Food Processing Technology of Zhejiang Province, Ningbo University, Ningbo, 315211, China
| | - Hongfei Wang
- Key Laboratory of Animal Protein Food Processing Technology of Zhejiang Province, Ningbo University, Ningbo, 315211, China
| | - Guanghong Zhou
- Key Laboratory of Meat Processing and Quality Control, MOE, Nanjing Agricultural University, Nanjing, 210095, P. R. China
| | - Jinxuan Cao
- State Key Laboratory for Managing Biotic and Chemical Threats to the Quality and Safety of Agro-products, Ningbo University, Ningbo, 315211, China.,Key Laboratory of Animal Protein Food Processing Technology of Zhejiang Province, Ningbo University, Ningbo, 315211, China
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17
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Kurabayashi T, Suzuki Y, Asato H. Extensor tendon repairing with a rolled deep temporal fascial graft and a free temporoparietal fascial flap as a gliding bed: A case report. JPRAS Open 2020; 23:75-79. [PMID: 32158909 PMCID: PMC7061604 DOI: 10.1016/j.jpra.2019.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 11/28/2019] [Indexed: 11/26/2022] Open
Abstract
Reconstruction of combined skin and tendon loss in an injury of the dorsum of the hand is a challenging problem because it is required to achieve adequate excursion of the tendon. We herein report our case of extensor tendon repair for a dorsal hand injury using a rolled deep temporal fascial (DTF) graft and a free temporoparietal fascial flap. The patient regained satisfactory hand function with minimal donor site morbidity. DTF utilization as tendon grafts spares another incision for tendon grafting. Furthermore, one can integrate all the donor sites into the temporal region by choosing the scalp as a donor site for skin grafting. Patients can benefit from this procedure, which provides a functional reconstruction of the hand and leaves only inconspicuous donor site scars.
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Affiliation(s)
- Takashi Kurabayashi
- Department of Plastic and Reconstructive Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi 321-0293, Japan
| | - Yasutoshi Suzuki
- Department of Plastic and Reconstructive Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi 321-0293, Japan
| | - Hirotaka Asato
- Department of Plastic and Reconstructive Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi 321-0293, Japan
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18
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Lin J, Shi Y, Men Y, Wang X, Ye J, Zhang C. Mechanical Roles in Formation of Oriented Collagen Fibers. TISSUE ENGINEERING PART B-REVIEWS 2020; 26:116-128. [PMID: 31801418 DOI: 10.1089/ten.teb.2019.0243] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Collagen is a structural protein that is widely present in vertebrates, being usually distributed in tissues in the form of fibers. In living organisms, fibers are organized in different orientations in various tissues. As the structural base in connective tissue and load-bearing tissue, the orientation of collagen fibers plays an extremely important role in the mechanical properties and physiological and biochemical functions. The study on mechanics role in formation of oriented collagen fibers enables us to understand how discrete cells use limited molecular materials to create tissues with different structures, thereby promoting our understanding of the mechanism of tissue formation from scratch, from invisible to tangible. However, the current understanding of the mechanism of fiber orientation is still insufficient. In addition, existing fabrication methods of oriented fibers are varied and involve interdisciplinary study, and the achievements of each experiment are favorable to the construction and improvement of the fiber orientation theory. To this end, this review focuses on the preparation methods of oriented fibers and proposes a model explaining the formation process of oriented fibers in tendons based on the existing fiber theory. Impact statement As the structural base in connective tissue and load-bearing tissue, the orientation of collagen fibers plays an extremely important role in the mechanical properties and physiological and biochemical functions. However, the current understanding of the mechanism of fiber orientation is still insufficient, which is greatly responsible for the challenge of functional tissue repair and regeneration. Understanding the mechanism of fiber orientation can promote the successful application of fiber orientation scaffolds in tissue repair and regeneration, as well as providing an insight for the mechanism of tissue histomorphology.
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Affiliation(s)
- Jiexiang Lin
- Tianjin Key Laboratory for Advanced Mechatronic System Design and Intelligent Control, National Demonstration Center for Experimental Mechanical and Electrical Engineering Education, School of Mechanical Engineering, Tianjin University of Technology, Tianjin, P.R. China
| | - Yanping Shi
- Tianjin Key Laboratory for Advanced Mechatronic System Design and Intelligent Control, National Demonstration Center for Experimental Mechanical and Electrical Engineering Education, School of Mechanical Engineering, Tianjin University of Technology, Tianjin, P.R. China
| | - Yutao Men
- Tianjin Key Laboratory for Advanced Mechatronic System Design and Intelligent Control, National Demonstration Center for Experimental Mechanical and Electrical Engineering Education, School of Mechanical Engineering, Tianjin University of Technology, Tianjin, P.R. China
| | - Xin Wang
- Tianjin Key Laboratory for Advanced Mechatronic System Design and Intelligent Control, National Demonstration Center for Experimental Mechanical and Electrical Engineering Education, School of Mechanical Engineering, Tianjin University of Technology, Tianjin, P.R. China
| | - Jinduo Ye
- Tianjin Key Laboratory for Advanced Mechatronic System Design and Intelligent Control, National Demonstration Center for Experimental Mechanical and Electrical Engineering Education, School of Mechanical Engineering, Tianjin University of Technology, Tianjin, P.R. China
| | - Chunqiu Zhang
- Tianjin Key Laboratory for Advanced Mechatronic System Design and Intelligent Control, National Demonstration Center for Experimental Mechanical and Electrical Engineering Education, School of Mechanical Engineering, Tianjin University of Technology, Tianjin, P.R. China
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19
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Taye N, Karoulias SZ, Hubmacher D. The "other" 15-40%: The Role of Non-Collagenous Extracellular Matrix Proteins and Minor Collagens in Tendon. J Orthop Res 2020; 38:23-35. [PMID: 31410892 PMCID: PMC6917864 DOI: 10.1002/jor.24440] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 08/02/2019] [Indexed: 02/04/2023]
Abstract
Extracellular matrix (ECM) determines the physiological function of all tissues, including musculoskeletal tissues. In tendon, ECM provides overall tissue architecture, which is tailored to match the biomechanical requirements of their physiological function, that is, force transmission from muscle to bone. Tendon ECM also constitutes the microenvironment that allows tendon-resident cells to maintain their phenotype and that transmits biomechanical forces from the macro-level to the micro-level. The structure and function of adult tendons is largely determined by the hierarchical organization of collagen type I fibrils. However, non-collagenous ECM proteins such as small leucine-rich proteoglycans (SLRPs), ADAMTS proteases, and cross-linking enzymes play critical roles in collagen fibrillogenesis and guide the hierarchical bundling of collagen fibrils into tendon fascicles. Other non-collagenous ECM proteins such as the less abundant collagens, fibrillins, or elastin, contribute to tendon formation or determine some of their biomechanical properties. The interfascicular matrix or endotenon and the outer layer of tendons, the epi- and paratenon, includes collagens and non-collagenous ECM proteins, but their function is less well understood. The ECM proteins in the epi- and paratenon may provide the appropriate microenvironment to maintain the identity of distinct tendon cell populations that are thought to play a role during repair processes after injury. The aim of this review is to provide an overview of the role of non-collagenous ECM proteins and less abundant collagens in tendon development and homeostasis. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:23-35, 2020.
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Affiliation(s)
- Nandaraj Taye
- Leni & Peter W. May Department of Orthopaedics, Orthopaedic Research LaboratoriesIcahn School of Medicine at Mt. SinaiNew York New York 10029
| | - Stylianos Z. Karoulias
- Leni & Peter W. May Department of Orthopaedics, Orthopaedic Research LaboratoriesIcahn School of Medicine at Mt. SinaiNew York New York 10029
| | - Dirk Hubmacher
- Leni & Peter W. May Department of Orthopaedics, Orthopaedic Research LaboratoriesIcahn School of Medicine at Mt. SinaiNew York New York 10029
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20
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A Tppp3 +Pdgfra + tendon stem cell population contributes to regeneration and reveals a shared role for PDGF signalling in regeneration and fibrosis. Nat Cell Biol 2019; 21:1490-1503. [PMID: 31768046 PMCID: PMC6895435 DOI: 10.1038/s41556-019-0417-z] [Citation(s) in RCA: 122] [Impact Index Per Article: 24.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 09/27/2019] [Indexed: 12/27/2022]
Abstract
Tendon injuries cause prolonged disability and never recover completely. Current mechanistic understanding of tendon regeneration is limited. Here we use single cell transcriptomics to identify a tubulin polymerization-promoting protein family member 3-expressing (Tppp3+) cell population as potential tendon stem cells. Through inducible lineage tracing, we demonstrated that these cells can generate new tenocytes and self-renew upon injury. A fraction of Tppp3+ cells expresses platelet-derived growth factor receptor alpha (Pdfgra). Ectopic platelet-derived growth factor-AA (PDGF-AA) protein induces new tenocyte production while inactivation of Pdgfra in Tppp3+ cells blocks tendon regeneration. These results support Tppp3+Pdgfra+ cells as tendon stem cells. Unexpectedly, Tppp3−Pdgfra+ fibro-adipogenic progenitors coexist in tendon stem cell niche and give rise to fibrotic cells, revealing a clandestine origin of fibrotic scars in healing tendons. Our results explain why fibrosis occurs in injured tendons and present clinical challenges to enhance tendon regeneration without a concurrent increase in fibrosis by PDGF application.
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21
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Sawadkar P, Sibbons P, Ahmed T, Bozec L, Mudera V. Engineering of a Functional Tendon Using Collagen As a Natural Polymer. ACS Biomater Sci Eng 2019; 5:5218-5228. [PMID: 33455227 DOI: 10.1021/acsbiomaterials.8b01544] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Reconstruction of a tendon rupture is surgically challenging as each end of the tendon retracts, leaving a substantial gap and direct repair is often not feasible. A tendon graft is required to bridge this defect and restore function. Presently, these gaps are filled with auto-, allo-, or synthetic grafts, but they all have clinical limitations. To address this issue, we developed tissue-engineered grafts by a rapid process using compressed type I collagen, which is the most dominant protein in the tendon. However, biomechanical properties were found to be unsuitable to withstand complete load-bearing in vivo. Hence, a modified suture technique was previously developed to reduce the load on the engineered collagen graft to aid integration in vivo. Using this technique, we tested engineered collagen grafts in vivo on a lapine model in three groups up to 12 weeks without immobilization. Gross observation at 3 and 12 weeks showed the bridge integrated without adhesions with a significant increase in the mechanical, structural and histological properties as compared to 1 week. Insertion of a tissue-engineered collagen graft using a novel load-bearing suture technique which partially loads in vivo showed integration, greater mechanical strength and no adhesion formation in the time period tested. This collagen graft has inherent advantages as compared to the present-day tendon grafts.
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Affiliation(s)
- Prasad Sawadkar
- Division of Surgery and interventional Science, University College London Stanmore Campus, London HA7 4LP, United Kingdom
| | - Paul Sibbons
- Department of Surgical Research, Northwick Park Institute of Medical Research, London HA1 3UJ, United Kingdom
| | - Tarek Ahmed
- Division of Biomaterials and Tissue Engineering, University College London Eastman Dental Institute, London WC1X 8LD, United Kingdom
| | - Laurent Bozec
- Division of Biomaterials and Tissue Engineering, University College London Eastman Dental Institute, London WC1X 8LD, United Kingdom
| | - Vivek Mudera
- Division of Surgery and interventional Science, University College London Stanmore Campus, London HA7 4LP, United Kingdom
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22
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Ma T, Song L, Ning S, Wang H, Zhang G, Wu Z. Relationship between the incidence of de Quervain's disease among teenagers and mobile gaming. INTERNATIONAL ORTHOPAEDICS 2019; 43:2587-2592. [PMID: 31463625 DOI: 10.1007/s00264-019-04389-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 08/06/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To assess the relationship between the incidence of de Quervain's disease (DD) and mobile gaming. METHODS We conducted an experimental cross-sectional study and surveyed specialized students with different majors from Xingtai Technician Institute. We applied the stratified clustered sampling method to recruit 500 students aged 16 to 20 years as survey respondents. We diagnosed DD by conducting Finkelstein's test. Chi-square test or Fisher's exact test was used to determine the correlation between different variables and Finkelstein's test results. SPSS 20 statistical software was used to perform all the statistical analyses. RESULTS Among the five hundred students providing the valid data, there were 302 males and 198 females, with a male-to-female ratio of 3:2. Of them, 216, 159, 77, and 48 reported they played mobile games for < two, two to four, four to six, and > six hours per day, respectively. A total of 246 students (49%) had a positive result in Finkelstein's test. Three hundred and five (61.0%) students played mobile games with their wrist in dorsiflexion position, and among them, 192 had a positive result in Finkelstein's test. The statistical analyses showed that more frequent play, prolonged mobile gaming time per day, and changes in wrist position were significantly correlated with the positive rate of Finkelstein's test (p < 0.05). DISCUSSION Our results show that the incidence of DD in students in the school was 49.0%. More frequent play, prolonged duration of mobile gaming, and change in wrist position were associated with higher risk of DD. We advocate the restricted time to less than 2.25 hours per day and the frequency in mobile gaming to prevent or reduce DD.
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Affiliation(s)
- Tianxiao Ma
- Department of Orthopaedic Surgery, The Orthopedics Hospital of Xingtai City, NO.202 Bayi Street, Xingtai, Hebei, People's Republic of China
| | - Lihua Song
- Department of Orthopaedic Surgery, The Orthopedics Hospital of Xingtai City, NO.202 Bayi Street, Xingtai, Hebei, People's Republic of China.
| | - Shenghua Ning
- Department of Orthopaedic Surgery, The Orthopedics Hospital of Xingtai City, NO.202 Bayi Street, Xingtai, Hebei, People's Republic of China
| | - Huiwang Wang
- Department of Orthopaedic Surgery, The Orthopedics Hospital of Xingtai City, NO.202 Bayi Street, Xingtai, Hebei, People's Republic of China
| | - Guisheng Zhang
- Department of Hand Surgery, The Third Hospital of Hebei Medical University, Ziqiang Road, Shijiazhuang, Hebei, People's Republic of China
| | - Zhanyong Wu
- Department of Orthopaedic Surgery, The Orthopedics Hospital of Xingtai City, NO.202 Bayi Street, Xingtai, Hebei, People's Republic of China.
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23
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Kouno M, Ishigaki T, Ikebukuro T, Yata H, Kubo K. Effects of the strain rate on mechanical properties of tendon structures in knee extensors and plantar flexors in vivo. Sports Biomech 2019; 20:887-900. [PMID: 31232180 DOI: 10.1080/14763141.2019.1615541] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The purpose of present study was to investigate site differences in the effects of strain rate on tendon properties between knee extensors and plantar flexors. Elongation of tendon structures (L) in vastus lateralis and medial gastrocnemius muscles was measured by ultrasonography while participants performed ramp and ballistic contractions to their voluntary maximum, followed by ramp and sudden relaxation. The relationship between muscle force (Fm) and L was fit to linear regression, the slope of which was defined as stiffness of tendon structures. Hysteresis of tendon structures was calculated as ratio of area within Fm-L loop to area beneath loading portion of curve. In knee extensors and plantar flexors, L values at all force levels were significantly lower during ballistic than ramp contractions. However, no significant differences were observed in stiffness of tendon structures between two contractions at both measured sites. Hysteresis of tendon structures was significantly higher during ballistic than ramp contractions for knee extensors and plantar flexors. In conclusion, elongation of tendon structures was lower and hysteresis was greater during ballistic than ramp contractions. Furthermore, site differences in the effects of strain rate on tendon properties were not found between knee extensors and plantar flexors.
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Affiliation(s)
- Masahiro Kouno
- Department of Life Science, University of Tokyo, Tokyo, Japan
| | | | | | - Hideaki Yata
- Department of Human and Environmental Well-being, Wako University, Tokyo, Japan
| | - Keitaro Kubo
- Department of Life Science, University of Tokyo, Tokyo, Japan
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24
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Guzzoni V, Selistre-de-Araújo HS, Marqueti RDC. Tendon Remodeling in Response to Resistance Training, Anabolic Androgenic Steroids and Aging. Cells 2018; 7:E251. [PMID: 30544536 PMCID: PMC6316563 DOI: 10.3390/cells7120251] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 11/30/2018] [Accepted: 11/30/2018] [Indexed: 12/14/2022] Open
Abstract
Exercise training (ET), anabolic androgenic steroids (AAS), and aging are potential factors that affect tendon homeostasis, particularly extracellular matrix (ECM) remodeling. The goal of this review is to aggregate findings regarding the effects of resistance training (RT), AAS, and aging on tendon homeostasis. Data were gathered from our studies regarding the impact of RT, AAS, and aging on the calcaneal tendon (CT) of rats. We demonstrated a series of detrimental effects of AAS and aging on functional and biomechanical parameters, including the volume density of blood vessel cells, adipose tissue cells, tendon calcification, collagen content, the regulation of the major proteins related to the metabolic/development processes of tendons, and ECM remodeling. Conversely, RT seems to mitigate age-related tendon dysfunction. Our results suggest that AAS combined with high-intensity RT exert harmful effects on ECM remodeling, and also instigate molecular and biomechanical adaptations in the CT. Moreover, we provide further information regarding the harmful effects of AAS on tendons at a transcriptional level, and demonstrate the beneficial effects of RT against the age-induced tendon adaptations of rats. Our studies might contribute in terms of clinical approaches in favor of the benefits of ET against tendinopathy conditions, and provide a warning on the harmful effects of the misuse of AAS on tendon development.
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Affiliation(s)
- Vinicius Guzzoni
- Departamento de Biologia Molecular e Celular, Universidade Federal da Paraíba, João Pessoa 58051-970, Paraíba, Brazil.
| | | | - Rita de Cássia Marqueti
- Graduate Program of Rehabilitation Science, University of Brasilia, Distrito Federal, Brasília 70840-901, Distrito Federal, Brazil.
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25
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Carrizo LV, Tulli MJ, Abdala V. Postnatal growth of forelimb musculo-tendinous systems in sigmodontine rats (Rodentia: Cricetidae). J Mammal 2018. [DOI: 10.1093/jmammal/gyy084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Luz Valeria Carrizo
- Instituto de Biología Subtropical (IBS)-nodo Posadas, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET)-Universidad Nacional de Misiones (UNaM), Laboratorio de Genética Evolutiva, Félix de Azara, Posadas, Argentina
| | - María José Tulli
- Unidad Ejecutora Lillo-CONICET, Instituto de Herpetología-Fundación Miguel Lillo, Miguel Lillo, Tucumán, Argentina
| | - Virginia Abdala
- Instituto de Biodiversidad Neotropical (IBN), UNT-CONICET, Cátedra de Biología General, Facultad de Ciencias Naturales, UNT, Horco Mole, Yerba Buena, Tucumán, Argentina
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26
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Porter MM, Niksiar P. Multidimensional mechanics: Performance mapping of natural biological systems using permutated radar charts. PLoS One 2018; 13:e0204309. [PMID: 30265707 PMCID: PMC6161877 DOI: 10.1371/journal.pone.0204309] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 09/05/2018] [Indexed: 11/27/2022] Open
Abstract
Comparing the functional performance of biological systems often requires comparing multiple mechanical properties. Such analyses, however, are commonly presented using orthogonal plots that compare N ≤ 3 properties. Here, we develop a multidimensional visualization strategy using permutated radar charts (radial, multi-axis plots) to compare the relative performance distributions of mechanical systems on a single graphic across N ≥ 3 properties. Leveraging the fact that radar charts plot data in the form of closed polygonal profiles, we use shape descriptors for quantitative comparisons. We identify mechanical property-function correlations distinctive to rigid, flexible, and damage-tolerant biological materials in the form of structural ties, beams, shells, and foams. We also show that the microstructures of dentin, bone, tendon, skin, and cartilage dictate their tensile performance, exhibiting a trade-off between stiffness and extensibility. Lastly, we compare the feeding versus singing performance of Darwin’s finches to demonstrate the potential of radar charts for multidimensional comparisons beyond mechanics of materials.
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Affiliation(s)
- Michael M. Porter
- Department of Mechanical Engineering, Clemson University, Clemson, SC, Untied States of America
- * E-mail:
| | - Pooya Niksiar
- Department of Mechanical Engineering, Clemson University, Clemson, SC, Untied States of America
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27
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Rudavsky A, Cook J, Docking S. Quantifying proximal patellar tendon changes during adolescence in elite ballet dancers, a 2-year study. Scand J Med Sci Sports 2018; 28:2369-2374. [PMID: 29862593 DOI: 10.1111/sms.13235] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2018] [Indexed: 12/20/2022]
Abstract
Patellar tendon pathology appears to develop in young athletes. It is not known how this tendon develops through adolescence. This longitudinal study investigated proximal patellar tendon development during the adolescent growth spurt in young ballet dancers and identified whether puberty (estimated by maturity offset) had an effect on tendon development. Fifty two dancers (32 female and 20 male dancers, ages 11-18 at baseline) had ultrasound images of their tendons every 6 months for 2 years. Changes in tendon size (anterior-posterior diameter) on grayscale images and echogenicity, as quantified using ultrasound tissue characterization, were recorded each time. Maturity offset was calculated used to estimate peak height velocity (adolescent growth spurt). Maturity offset did not affect effect tendon composition before peak height velocity; however, after participants passed peak height velocity, maturity offset increased the composition of stable echopattern (P < .05): a 4% differential increase in type I echopattern, indicative of normal tendon structure, and a decrease in type III echopattern (more disorganized echopattern) by 0.7% per year. Anterior-posterior thickness increased by 0.2 mm/y (P < .05) measured 2 cm below the patella. Following peak height velocity, the proximal patellar tendon attachment increased in thickness and demonstrated a more stable echopattern representative of aligned fibrillar structure. Future research is required to further understand this normal maturation and the factors that support this process, with the aim of reducing the development of patellar tendon pathology in the adolescent jumping athlete.
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Affiliation(s)
- A Rudavsky
- Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery M, Bispebjerg Hospital and Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, København, Denmark
| | - J Cook
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, VIC, Australia
| | - S Docking
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, VIC, Australia
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28
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Guo J, Ling S, Li W, Chen Y, Li C, Omenetto FG, Kaplan DL. Coding cell micropatterns through peptide inkjet printing for arbitrary biomineralized architectures. ADVANCED FUNCTIONAL MATERIALS 2018; 28:1800228. [PMID: 32440260 PMCID: PMC7241601 DOI: 10.1002/adfm.201800228] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Indexed: 05/20/2023]
Abstract
Well-designed micropatterns present in native tissues and organs involve changes in extracellular matrix compositions, cell types and mechanical properties to reflect complex biological functions. However, the design and fabrication of these micropatterns in vitro to meet task-specific biomedical applications remains a challenge. A de novo design strategy to code and synthesize functional micropatterns is presented to engineer cell alignment through the integration of aqueous-peptide inkjet printing and site-specific biomineralization. The inkjet printing provides direct writing of macroscopic biosilica selective peptide-R5 patterns with micrometer-scale resolution on the surface of a biopolymer (silk) hydrogel. This is combined with in situ biomineralization of the R5 peptide for site-specific growth of silica nanoparticles on the micropatterns, avoiding the use of harsh chemicals or complex processing. The functional micropatterned systems are used to align human mesenchymal stem cells and bovine serum albumin. This combination of peptide printing and site-specific biomineralization provides a new route for developing cost-effective micropatterns, with implications for broader materials designs. Coding cell micropatterns through peptide inkjet printing for arbitrary biomineralized architectures is demonstrated here. The functional micropatterned systems are used to align human mesenchymal stem cells and bovine serum albumin in vitro, avoiding the use of harsh chemicals or complex processing, while providing potential applications in developing cost-effective micropatterns to meet task-specific biomedical applications.
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Affiliation(s)
- Jin Guo
- Department of Biomedical Engineering, Tufts University, MA 02155, USA
| | - Shengjie Ling
- Department of Biomedical Engineering, Tufts University, MA 02155, USA
| | - Wenyi Li
- Department of Biomedical Engineering, Tufts University, MA 02155, USA
| | - Ying Chen
- Department of Biomedical Engineering, Tufts University, MA 02155, USA
| | - Chunmei Li
- Department of Biomedical Engineering, Tufts University, MA 02155, USA
| | | | - David L Kaplan
- Department of Biomedical Engineering, Tufts University, MA 02155, USA
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29
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Wang Y, Zhang X, Huang H, Xia Y, Yao Y, Mak AFT, Yung PSH, Chan KM, Wang L, Zhang C, Huang Y, Mak KKL. Osteocalcin expressing cells from tendon sheaths in mice contribute to tendon repair by activating Hedgehog signaling. eLife 2017; 6. [PMID: 29244023 PMCID: PMC5731821 DOI: 10.7554/elife.30474] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 12/05/2017] [Indexed: 11/25/2022] Open
Abstract
Both extrinsic and intrinsic tissues contribute to tendon repair, but the origin and molecular functions of extrinsic tissues in tendon repair are not fully understood. Here we show that tendon sheath cells harbor stem/progenitor cell properties and contribute to tendon repair by activating Hedgehog signaling. We found that Osteocalcin (Bglap) can be used as an adult tendon-sheath-specific marker in mice. Lineage tracing experiments show that Bglap-expressing cells in adult sheath tissues possess clonogenic and multipotent properties comparable to those of stem/progenitor cells isolated from tendon fibers. Transplantation of sheath tissues improves tendon repair. Mechanistically, Hh signaling in sheath tissues is necessary and sufficient to promote the proliferation of Mkx-expressing cells in sheath tissues, and its action is mediated through TGFβ/Smad3 signaling. Furthermore, co-localization of GLI1+ and MKX+ cells is also found in human tendinopathy specimens. Our work reveals the molecular function of Hh signaling in extrinsic sheath tissues for tendon repair.
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Affiliation(s)
- Yi Wang
- Developmental and Regenerative Biology, School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Xu Zhang
- Developmental and Regenerative Biology, School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Huihui Huang
- Developmental and Regenerative Biology, School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Yin Xia
- Developmental and Regenerative Biology, School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - YiFei Yao
- Division of Biomedical Engineering, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Arthur Fuk-Tat Mak
- Division of Biomedical Engineering, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Patrick Shu-Hang Yung
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Prince of Wales Hospital, Sha Tin, Hong Kong
| | - Kai-Ming Chan
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Prince of Wales Hospital, Sha Tin, Hong Kong
| | - Li Wang
- Neural, Vascular and Metabolic Biology, School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Chenglin Zhang
- Neural, Vascular and Metabolic Biology, School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Yu Huang
- Neural, Vascular and Metabolic Biology, School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Kingston King-Lun Mak
- Developmental and Regenerative Biology, School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong
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30
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Rudavsky A, Cook J, Magnusson SP, Kjaer M, Docking S. Characterising the proximal patellar tendon attachment and its relationship to skeletal maturity in adolescent ballet dancers. Muscles Ligaments Tendons J 2017; 7:306-314. [PMID: 29264342 DOI: 10.11138/mltj/2017.7.2.306] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background It is unknown how and when the proximal attachment of the patellar tendon matures; puberty may be key in ensuring normal tendon formation. The aim of this study was to investigate the features of the proximal patellar tendon attachment at different stages of skeletal maturity, to help gain an understanding of how and when the tendon attachment matures. Methods Sixty adolescent elite ballet students (ages 11-18) and eight mature adults participated. Peak height velocity (PHV) estimated skeletal maturity. Ultrasound tissue characterisation (UTC) scan was taken of the left knee and analysed for stability of echopattern. An image-based grading scale for greyscale ultrasound was developed to describe the tendon appearance. Anterior-posterior thickness was measured at the inferior pole of the patella, 1 and 2 centimetres distally. Outcomes were compared with skeletal maturity. Results Mid-portion patellar tendon thickness increased with skeletal maturity (p=0.001 at 1 cm and p=0.007 at 2 cm). There was more variance in structural appearance (greyscale classification and UTC echopattern) in pre and peri-PHV participants. Tendon attachment one-year post PHV appeared similar to mature tendons. Conclusions Early adolescence was associated with highly variable tendon appearance, whereas the tendon appeared mature after PHV. Adolescence may be a critical time for the formation of normal tendon attachment. Level of evidence IIb individual cohort study.
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Affiliation(s)
- Aliza Rudavsky
- Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery M, Bispebjerg Hospital and Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Jillianne Cook
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Stig Peter Magnusson
- Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery M, Bispebjerg Hospital and Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.,Musculoskeletal Rehabilitation Research Unit, Department of Physical Therapy, Bispebjerg Hospital, Copenhagen, Denmark
| | - Michael Kjaer
- Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery M, Bispebjerg Hospital and Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Sean Docking
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
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31
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Patel D, Sharma S, Bryant SJ, Screen HRC. Recapitulating the Micromechanical Behavior of Tension and Shear in a Biomimetic Hydrogel for Controlling Tenocyte Response. Adv Healthc Mater 2017; 6. [PMID: 28026126 PMCID: PMC5469035 DOI: 10.1002/adhm.201601095] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 11/21/2016] [Indexed: 12/11/2022]
Abstract
A fiber composite system is presented which recapitulates the fiber-composite-like nature of tissues and generates similar modes of shear and tension. The shear/tension ratio can be customized during composite manufacture and incorporates viable cells. The system is a valuable tool for mechanotransduction research, providing a platform with physiologically relevant conditions for investigating cell behavior in different tissue types.
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Affiliation(s)
- Dharmesh Patel
- School of Engineering and Materials Science; Queen Mary University of London; Mile End Road London E1 4NS UK
| | - Sadhana Sharma
- Department of Chemical and Biological Engineering; University of Colorado Boulder; Boulder CO 80303 USA
| | - Stephanie J. Bryant
- Department of Chemical and Biological Engineering; Material Science and Engineering Program; BioFrontiers Institute; University of Colorado; Boulder CO 80303 USA
| | - Hazel R. C. Screen
- School of Engineering and Materials Science; Queen Mary University of London; Mile End Road London E1 4NS UK
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32
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Klein JA, Hickey DS, Hukins DWL. Computer Graphics Illustration of the Operation of the Intervertebral Disc. ACTA ACUST UNITED AC 2016. [DOI: 10.1243/emed_jour_1982_011_004_02] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The annulus fibrosus, the outer wall of the intervertebral disc, has a lamellar structure. Each lamella is reinforced by collagen fibres. A theory has been developed which allows the response of the fibre network to disc deformation to be calculated. The theory has been formulated in a form suitable for computer graphics display of its predictions. Results enable the effects of compression, torsion, flexion and shear of the disc to be readily appreciated.
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Affiliation(s)
- J A Klein
- Department of Medical Biophysics, University of Manchester
| | - D S Hickey
- Department of Geriatric Medicine, University Hospital of South Manchester
| | - D W L Hukins
- Department of Medical Biophysics, University of Manchester
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33
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Hukins DW, Aspden RM, Yarker YE. Fibre Reinforcement and Mechanical Stability in Articular Cartilage. ACTA ACUST UNITED AC 2016; 13:153-6. [PMID: 6542886 DOI: 10.1243/emed_jour_1984_013_036_02] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The gel phase of articular cartilage is reinforced by collagen fibrils. These fibrils have low flexural and torsional stiffness, but are able to provide reinforcement if deformation of the tissue increases their tensile stress. An estimate suggests that the lengths of collagen fibrils in articular cartilage are at least of the same order as their critical length so that tensile stress in the tissue will increase the stress in the fibrils rather than simply pull them out of the gel. In the surface zone the collagen fibrils are oriented so that the efficiency of reinforcement, η, is about 0.6 tangential to the surface; tension in the fibrils is thus able to withstand swelling pressure within the tissue whose condition for stability resembles that of a pressure vessel. Swelling pressure allows the tissue to support applied pressure. An intermediate zone has a roughly isotropic η value of about 0.2, while in the deep zone collagen fibrils appear to tie the cartilage to the subchondral bone; in this deep zone η has a value of about 0.6 perpendicular to the surface direction. There is also some preferred orientation of collagen fibrils in the plane of the articular surface within the surface zone; in patellar cartilage the preferred orientations can be related to the direction of stress which could be generated by movement of the joint.
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34
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Ishigaki T, Kouno M, Ikebukuro T, Kubo K. Quantification of collagen fiber orientation in human tendons with the coefficient of variation of echogenicity. J Biomech 2016; 49:3923-3927. [DOI: 10.1016/j.jbiomech.2016.11.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 10/28/2016] [Accepted: 11/02/2016] [Indexed: 11/25/2022]
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35
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Shah JS, Jayson MIV, Hampson WGJ. Mechanical Implications of Crimping in Collagen Fibres of Human Spinal Ligaments. ACTA ACUST UNITED AC 2016. [DOI: 10.1243/emed_jour_1979_008_023_02] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The crimp morphology of collagen fibres from human cadaveric anterior longitudinal, posterior longitudinal and interspinous ligaments was demonstrated by the analysis of extinction and transmission bands seen across the axis of the fibres on transmission polarization microscopy. The experimentally observed force/strain behaviour of the fibres at low tensile forces was correlated quantitatively with their crimp structure. The initial extension of the fibres in the toe region of the stress-strain curve can be attributed to the deformity of crimps. Further confirmation of the crimp morphology, notably in rat tail tendons, by scanning electron microscopy, X-ray diffraction and transmission electron microscopy is discussed. Finally, it is suggested the crimp structure does alter in diseases and ageing. This may account for associated changes in the mechanical behaviour of the tissues.
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Affiliation(s)
- J S Shah
- H H Wills Physics Laboratory, Bristol
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36
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CLEMMER JOHN, PRABHU RAJ, CHEN JOSEPH, COLEBECK ERIN, PRIDDY LAURENB, MCCOLLUM MICHAEL, BRAZILE BRYN, WHITTINGTON WILBUR, WARDLAW JENNIFERL, RHEE HONGJOO, HORSTEMEYER MF, WILLIAMS LAKIESHAN, LIAO JUN. EXPERIMENTAL OBSERVATION OF HIGH STRAIN RATE RESPONSES OF PORCINE BRAIN, LIVER, AND TENDON. J MECH MED BIOL 2016. [DOI: 10.1142/s0219519416500329] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
High strain rate compression of soft tissues has recently gained attention due to its application in computational simulation of traumatic injuries. To understand high rate tissue behavior, a comparative study is needed to examine the biomechanical responses of multiple soft tissues. We hypothesized that the underlying mechanisms of soft tissue high rate compression is dependent upon water, microstructural organization, and extracellular matrix (ECM). Porcine brain, liver, and tendon, which have similar material density (brain: 1.05[Formula: see text]g/cm3, liver: 1.06[Formula: see text]g/cm3, and tendon: 1.12[Formula: see text]g/cm3) and water content (brain: [Formula: see text][Formula: see text]78%, liver: [Formula: see text][Formula: see text]71–75%, and tendon: [Formula: see text][Formula: see text]70%) but different cellularity and ECM properties, were subjected to polymeric split Hopkinson pressure bar (PSHPB) testing. Hydrated brain tissue, due to its high microstructural cavities (cavity area [Formula: see text]) and low ECM content, had a high initial stress spike of [Formula: see text][Formula: see text]MPa. Hydrated liver, with moderate microstructural cavities (cavity area [Formula: see text]) and moderate ECM content, had a moderate stress spike of [Formula: see text][Formula: see text]MPa. Hydrated tendon had low microstructural cavities (cavity area [Formula: see text]) and high ECM content and had a minimal initial stress spike of [Formula: see text][Formula: see text]MPa. Electron microscopy of the tissues’ microstructural cavities revealed a first-order estimation of water content that was not bound to ECM (e.g., intracellular water). Linear regression analysis showed that the initial spike was highly correlated ([Formula: see text]) with intracellular water. To understand the role of water in each tissue’s response to high deformation, each soft tissue was completely dehydrated and subjected to the same PSHPB compression test. After removal of all the water, neither the brain, liver, nor tendon revealed an initial stress spike, implicating the essential nature of water in the initial responses of high-rate compression. These results suggest that cellular water and ECM content play a critical role in the biomechanical responses to high strain rate compression.
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Affiliation(s)
- JOHN CLEMMER
- Tissue Bioengineering Laboratory and Injury Mechanics Laboratory, Department of Biological Engineering, Mississippi State University, Mississippi State, MS 39762, USA
| | - RAJ PRABHU
- Tissue Bioengineering Laboratory and Injury Mechanics Laboratory, Department of Biological Engineering, Mississippi State University, Mississippi State, MS 39762, USA
- Computational Manufacture and Design, Center for Advanced Vehicular Systems, Mississippi State University, Mississippi State, MS 39762, USA
| | - JOSEPH CHEN
- Tissue Bioengineering Laboratory and Injury Mechanics Laboratory, Department of Biological Engineering, Mississippi State University, Mississippi State, MS 39762, USA
| | - ERIN COLEBECK
- Tissue Bioengineering Laboratory and Injury Mechanics Laboratory, Department of Biological Engineering, Mississippi State University, Mississippi State, MS 39762, USA
| | - LAUREN B. PRIDDY
- Tissue Bioengineering Laboratory and Injury Mechanics Laboratory, Department of Biological Engineering, Mississippi State University, Mississippi State, MS 39762, USA
- Computational Manufacture and Design, Center for Advanced Vehicular Systems, Mississippi State University, Mississippi State, MS 39762, USA
| | - MICHAEL MCCOLLUM
- Computational Manufacture and Design, Center for Advanced Vehicular Systems, Mississippi State University, Mississippi State, MS 39762, USA
| | - BRYN BRAZILE
- Tissue Bioengineering Laboratory and Injury Mechanics Laboratory, Department of Biological Engineering, Mississippi State University, Mississippi State, MS 39762, USA
- Computational Manufacture and Design, Center for Advanced Vehicular Systems, Mississippi State University, Mississippi State, MS 39762, USA
| | - WILBUR WHITTINGTON
- Computational Manufacture and Design, Center for Advanced Vehicular Systems, Mississippi State University, Mississippi State, MS 39762, USA
| | - JENNIFER L. WARDLAW
- College of Veterinary Medicine, Mississippi State University, Mississippi State, MS 39762, USA
| | - HONGJOO RHEE
- Computational Manufacture and Design, Center for Advanced Vehicular Systems, Mississippi State University, Mississippi State, MS 39762, USA
| | - M. F. HORSTEMEYER
- Computational Manufacture and Design, Center for Advanced Vehicular Systems, Mississippi State University, Mississippi State, MS 39762, USA
| | - LAKIESHA N. WILLIAMS
- Tissue Bioengineering Laboratory and Injury Mechanics Laboratory, Department of Biological Engineering, Mississippi State University, Mississippi State, MS 39762, USA
- Computational Manufacture and Design, Center for Advanced Vehicular Systems, Mississippi State University, Mississippi State, MS 39762, USA
| | - JUN LIAO
- Tissue Bioengineering Laboratory and Injury Mechanics Laboratory, Department of Biological Engineering, Mississippi State University, Mississippi State, MS 39762, USA
- Computational Manufacture and Design, Center for Advanced Vehicular Systems, Mississippi State University, Mississippi State, MS 39762, USA
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Uchida TK, Hicks JL, Dembia CL, Delp SL. Stretching Your Energetic Budget: How Tendon Compliance Affects the Metabolic Cost of Running. PLoS One 2016; 11:e0150378. [PMID: 26930416 PMCID: PMC4773147 DOI: 10.1371/journal.pone.0150378] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 02/12/2016] [Indexed: 11/18/2022] Open
Abstract
Muscles attach to bones via tendons that stretch and recoil, affecting muscle force generation and metabolic energy consumption. In this study, we investigated the effect of tendon compliance on the metabolic cost of running using a full-body musculoskeletal model with a detailed model of muscle energetics. We performed muscle-driven simulations of running at 2–5 m/s with tendon force–strain curves that produced between 1 and 10% strain when the muscles were developing maximum isometric force. We computed the average metabolic power consumed by each muscle when running at each speed and with each tendon compliance. Average whole-body metabolic power consumption increased as running speed increased, regardless of tendon compliance, and was lowest at each speed when tendon strain reached 2–3% as muscles were developing maximum isometric force. When running at 2 m/s, the soleus muscle consumed less metabolic power at high tendon compliance because the strain of the tendon allowed the muscle fibers to operate nearly isometrically during stance. In contrast, the medial and lateral gastrocnemii consumed less metabolic power at low tendon compliance because less compliant tendons allowed the muscle fibers to operate closer to their optimal lengths during stance. The software and simulations used in this study are freely available at simtk.org and enable examination of muscle energetics with unprecedented detail.
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Affiliation(s)
- Thomas K. Uchida
- Department of Bioengineering, Stanford University, Stanford, California, United States of America
- * E-mail:
| | - Jennifer L. Hicks
- Department of Bioengineering, Stanford University, Stanford, California, United States of America
| | - Christopher L. Dembia
- Department of Mechanical Engineering, Stanford University, Stanford, California, United States of America
| | - Scott L. Delp
- Department of Bioengineering, Stanford University, Stanford, California, United States of America
- Department of Mechanical Engineering, Stanford University, Stanford, California, United States of America
- Department of Orthopaedic Surgery, Stanford University, Stanford, California, United States of America
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38
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Zhang J, Wang JHC. Moderate Exercise Mitigates the Detrimental Effects of Aging on Tendon Stem Cells. PLoS One 2015; 10:e0130454. [PMID: 26086850 PMCID: PMC4472753 DOI: 10.1371/journal.pone.0130454] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 05/20/2015] [Indexed: 12/25/2022] Open
Abstract
Aging is known to cause tendon degeneration whereas moderate exercise imparts beneficial effects on tendons. Since stem cells play a vital role in maintaining tissue integrity, in this study we aimed to define the effects of aging and moderate exercise on tendon stem/progenitor cells (TSCs) using in vitro and in vivo models. TSCs derived from aging mice (9 and 24 months) proliferated significantly slower than TSCs obtained from young mice (2.5 and 5 months). In addition, expression of the stem cell markers Oct-4, nucleostemin (NS), Sca-1 and SSEA-1 in TSCs decreased in an age-dependent manner. Interestingly, moderate mechanical stretching (4%) of aging TSCs in vitro significantly increased the expression of the stem cell marker, NS, but 8% stretching decreased NS expression. Similarly, 4% mechanical stretching increased the expression of Nanog, another stem cell marker, and the tenocyte-related genes, collagen I and tenomodulin. However, 8% stretching increased expression of the non-tenocyte-related genes, LPL, Sox-9 and Runx-2, while 4% stretching had minimal effects on the expression of these genes. In the in vivo study, moderate treadmill running (MTR) of aging mice (9 months) resulted in the increased proliferation rate of aging TSCs in culture, decreased lipid deposition, proteoglycan accumulation and calcification, and increased the expression of NS in the patellar tendons. These findings indicate that while aging impairs the proliferative ability of TSCs and reduces their stemness, moderate exercise can mitigate the deleterious effects of aging on TSCs and therefore may be responsible for decreased aging-induced tendon degeneration.
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Affiliation(s)
- Jianying Zhang
- MechanoBiology Laboratory, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - James H-C. Wang
- MechanoBiology Laboratory, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Department of Mechanical Engineering and Materials Science, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- * E-mail:
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39
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Freedman BR, Zuskov A, Sarver JJ, Buckley MR, Soslowsky LJ. Evaluating changes in tendon crimp with fatigue loading as an ex vivo structural assessment of tendon damage. J Orthop Res 2015; 33:904-10. [PMID: 25773654 PMCID: PMC4416993 DOI: 10.1002/jor.22875] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Accepted: 02/13/2015] [Indexed: 02/04/2023]
Abstract
The complex structure of tendons relates to their mechanical properties. Previous research has associated the waviness of collagen fibers (crimp) during quasi-static tensile loading to tensile mechanical properties, but less is known about the role of fatigue loading on crimp properties. In this study (IACUC approved), mouse patellar tendons were fatigue loaded while an integrated plane polariscope simultaneously assessed crimp properties. We demonstrate a novel structural mechanism whereby tendon crimp amplitude and frequency are altered with fatigue loading. In particular, fatigue loading increased the crimp amplitude across the tendon width and length, and these structural alterations were shown to be both region and load dependent. The change in crimp amplitude was strongly correlated to mechanical tissue laxity (defined as the ratio of displacement and gauge length relative to the first cycle of fatigue loading assessed at constant load throughout testing), at all loads and regions evaluated. Together, this study highlights the role of fatigue loading on tendon crimp properties as a function of load applied and region evaluated, and offers an additional structural mechanism for mechanical alterations that may lead to ultimate tendon failure.
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Affiliation(s)
- Benjamin R. Freedman
- McKay Orthopaedic Research Laboratory, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Joseph J. Sarver
- McKay Orthopaedic Research Laboratory, University of Pennsylvania, Philadelphia, PA, USA,Department of Biomedical Engineering, Drexel University, Philadelphia, PA, USA
| | - Mark R. Buckley
- McKay Orthopaedic Research Laboratory, University of Pennsylvania, Philadelphia, PA, USA,Department of Biomedical Engineering, University of Rochester, Rochester, NY, USA
| | - Louis J. Soslowsky
- McKay Orthopaedic Research Laboratory, University of Pennsylvania, Philadelphia, PA, USA
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40
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Ryan CNM, Sorushanova A, Lomas AJ, Mullen AM, Pandit A, Zeugolis DI. Glycosaminoglycans in Tendon Physiology, Pathophysiology, and Therapy. Bioconjug Chem 2015; 26:1237-51. [DOI: 10.1021/acs.bioconjchem.5b00091] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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41
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Böl M, Ehret AE, Leichsenring K, Ernst M. Tissue-scale anisotropy and compressibility of tendon in semi-confined compression tests. J Biomech 2015; 48:1092-8. [DOI: 10.1016/j.jbiomech.2015.01.024] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 01/16/2015] [Accepted: 01/20/2015] [Indexed: 01/22/2023]
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42
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Bohm S, Mersmann F, Arampatzis A. Human tendon adaptation in response to mechanical loading: a systematic review and meta-analysis of exercise intervention studies on healthy adults. SPORTS MEDICINE-OPEN 2015; 1:7. [PMID: 27747846 PMCID: PMC4532714 DOI: 10.1186/s40798-015-0009-9] [Citation(s) in RCA: 230] [Impact Index Per Article: 25.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Accepted: 01/29/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND The present article systematically reviews recent literature on the in vivo adaptation of asymptomatic human tendons following increased chronic mechanical loading, and meta-analyzes the loading conditions, intervention outcomes, as well as methodological aspects. METHODS The search was performed in the databases PubMed, Web of Knowledge, and Scopus as well as in the reference lists of the eligible articles. A study was included if it conducted (a) a longitudinal exercise intervention (≥8 weeks) on (b) healthy humans (18 to 50 years), (c) investigating the effects on mechanical (i.e., stiffness), material (i.e., Young's modulus) and/or morphological properties (i.e., cross-sectional area (CSA)) of tendons in vivo, and was reported (d) in English language. Weighted average effect sizes (SMD, random-effects) and heterogeneity (Q and I 2 statistics) of the intervention-induced changes of tendon stiffness, Young's modulus, and CSA were calculated. A subgroup analysis was conducted regarding the applied loading intensity, muscle contraction type, and intervention duration. Further, the methodological study quality and the risk of bias were assessed. RESULTS The review process yielded 27 studies with 37 separate interventions on either the Achilles or patellar tendon (264 participants). SMD was 0.70 (confidence interval: 0.51, 0.88) for tendon stiffness (N=37), 0.69 (0.36, 1.03) for Young's modulus (N=17), and 0.24 (0.07, 0.42) for CSA (N=33), with significant overall intervention effects (p<0.05). The heterogeneity analysis (stiffness: I 2 =30%; Young's modulus: I 2 =57%; CSA: I 2 =21%) indicated that differences in the loading conditions may affect the adaptive responses. The subgroup analysis confirmed that stiffness adaptation significantly (p<0.05) depends on loading intensity (I 2 =0%), but not on muscle contraction type. Although not significantly different, SMD was higher for interventions with longer duration (≥12 weeks). The average score of 71±9% in methodological quality assessment indicated an appropriate quality of most studies. CONCLUSIONS The present meta-analysis provides elaborate statistical evidence that tendons are highly responsive to diverse loading regimens. However, the data strongly suggests that loading magnitude in particular plays a key role for tendon adaptation in contrast to muscle contraction type. Furthermore, intervention-induced changes in tendon stiffness seem to be more attributed to adaptations of the material rather than morphological properties.
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Affiliation(s)
- Sebastian Bohm
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Philippstr. 13, Haus 11, 10115, Berlin, Germany
| | - Falk Mersmann
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Philippstr. 13, Haus 11, 10115, Berlin, Germany
| | - Adamantios Arampatzis
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Philippstr. 13, Haus 11, 10115, Berlin, Germany.
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Targeted deletion of collagen V in tendons and ligaments results in a classic Ehlers-Danlos syndrome joint phenotype. THE AMERICAN JOURNAL OF PATHOLOGY 2015; 185:1436-47. [PMID: 25797646 DOI: 10.1016/j.ajpath.2015.01.031] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 12/11/2014] [Accepted: 01/02/2015] [Indexed: 01/10/2023]
Abstract
Collagen V mutations underlie classic Ehlers-Danlos syndrome, and joint hypermobility is an important clinical manifestation. We define the function of collagen V in tendons and ligaments, as well as the role of alterations in collagen V expression in the pathobiology in classic Ehlers-Danlos syndrome. A conditional Col5a1(flox/flox) mouse model was bred with Scleraxis-Cre mice to create a targeted tendon and ligament Col5a1-null mouse model, Col5a1(Δten/Δten). Targeting was specific, resulting in collagen V-null tendons and ligaments. Col5a1(Δten/Δten) mice demonstrated decreased body size, grip weakness, abnormal gait, joint laxity, and early-onset osteoarthritis. These gross changes were associated with abnormal fiber organization, as well as altered collagen fibril structure with increased fibril diameters and decreased fibril number that was more severe in a major joint stabilizing ligament, the anterior cruciate ligament (ACL), than in the flexor digitorum longus tendon. The ACL also had a higher collagen V content than did the flexor digitorum longus tendon. The collagen V-null ACL and flexor digitorum longus tendon both had significant alterations in mechanical properties, with ACL exhibiting more severe changes. The data demonstrate critical differential regulatory roles for collagen V in tendon and ligament structure and function and suggest that collagen V regulatory dysfunction is associated with an abnormal joint phenotype, similar to the hypermobility phenotype in classic Ehlers-Danlos syndrome.
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44
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Zhao L, Thambyah A, Broom N. Crimp morphology in the ovine anterior cruciate ligament. J Anat 2015; 226:278-88. [PMID: 25677165 DOI: 10.1111/joa.12276] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2014] [Indexed: 11/30/2022] Open
Abstract
While the crimp morphology in ligaments and tendons has been described in detail in the literature, its relative distribution within the tissue has not been studied, especially in relation to the complex multi-bundle arrangement as is found in the anterior cruciate ligament (ACL). In this study, the crimp morphology of the ovine ACL was examined topologically and with respect to its double-bundle structure. The crimp morphologies were compared with the knee in three knee positions, namely stance, maximum extension and maximum flexion. As a control, the crimp morphology of the ACL free from its bony attachments was determined. In the control samples, the anterior-medial (AM) bundle contained a combination of coarse and fine crimp, whereas the posterior-lateral (PL) bundle manifested only a coarse crimp. Using the extent of crimp loss observed when subjecting the knee to the respective positions, and comparing with the controls, the crimp morphologies show that the AM bundle of the ACL is most active in the stance position, whereas for the maximum extension and flexion positions the PL bundle is most active. We propose that these differences in crimp morphologies have relevance to ACL design and function.
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Affiliation(s)
- Lei Zhao
- Experimental Tissue Mechanics Laboratory, Department of Chemical and Materials Engineering, University of Auckland, Auckland, New Zealand
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Hannah R, Folland JP. Muscle-tendon unit stiffness does not independently affect voluntary explosive force production or muscle intrinsic contractile properties. Appl Physiol Nutr Metab 2015; 40:87-95. [DOI: 10.1139/apnm-2014-0343] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study examined the relationship of muscle-tendon unit (MTU) stiffness and explosive force production during voluntary and evoked contractions of the knee extensors. Thirty-four untrained participants performed a series of explosive voluntary and electrically evoked (octets (8 pulses, 300 Hz) via femoral nerve stimulation) isometric contractions. Maximum voluntary force (MVF) was assessed during maximum voluntary contractions. Explosive force production was assessed as the time taken, from force onset (0 N), to achieve specific levels of absolute (25–300 N) and relative force (5%–75% MVF) during the explosive contractions. Ultrasonic images of the vastus lateralis were recorded during 10-s ramp contractions to assess MTU stiffness, which was expressed in absolute (N·mm−1) and relative (to MVF and resting tendon-aponeurosis length) terms. Bivariate correlations suggested that absolute MTU stiffness was associated with voluntary explosive force (time to achieve 150–300 N: r = –0.35 to –0.54, P < 0.05). However, no relationships between stiffness and voluntary explosive force were observed when the influence of MVF was removed, either via partial correlations of absolute values (P ≥ 0.49) or considering relative values (P ≥ 0.14). Similarly, absolute MTU stiffness was related to explosive force during evoked octet contractions (r = –0.41 to –0.64, P < 0.05), but these correlations were no longer present when accounting for the influence of MVF (P ≥ 0.15). Therefore, once maximum strength was considered, MTU stiffness had no independent relationship with voluntary explosive force production or the evoked capacity for explosive force.
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Affiliation(s)
- Ricci Hannah
- Sport, Health and Performance Enhancement (SHAPE) Research Group, School of Science and Technology, Nottingham Trent University, Nottingham, UK
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, UK
| | - Jonathan P. Folland
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, UK
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46
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Drug-induced tendinopathy: From physiology to clinical applications. Joint Bone Spine 2014; 81:485-92. [DOI: 10.1016/j.jbspin.2014.03.022] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2014] [Indexed: 11/22/2022]
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47
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Barfred T. Achilles Tendon Rupture: Aetiology and Pathogenesis of Subcutaneous Rupture Assessed on the Basis of the Literature and Rupture Experiments on Rats. ACTA ACUST UNITED AC 2014. [DOI: 10.3109/ort.1973.44.suppl-152.01] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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48
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Ho JO, Sawadkar P, Mudera V. A review on the use of cell therapy in the treatment of tendon disease and injuries. J Tissue Eng 2014; 5:2041731414549678. [PMID: 25383170 PMCID: PMC4221986 DOI: 10.1177/2041731414549678] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 07/28/2014] [Indexed: 12/28/2022] Open
Abstract
Tendon disease and injuries carry significant morbidity worldwide in both athletic and non-athletic populations. It is estimated that tendon injuries account for 30%−50% of all musculoskeletal injuries globally. Current treatments have been inadequate in providing an accelerated process of repair resulting in high relapse rates. Modern concepts in tissue engineering and regenerative medicine have led to increasing interest in the application of cell therapy for the treatment of tendon disease. This review will explore the use of cell therapy, by bringing together up-to-date evidence from in vivo human and animal studies, and discuss the issues surrounding the safety and efficacy of its use in the treatment of tendon disease.
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Affiliation(s)
- Jasmine Oy Ho
- Institute of Orthopaedics and Musculoskeletal Science (IOMS), Division of Surgery and Interventional Science, University College London, London, UK
| | - Prasad Sawadkar
- Institute of Orthopaedics and Musculoskeletal Science (IOMS), Division of Surgery and Interventional Science, University College London, London, UK
| | - Vivek Mudera
- Institute of Orthopaedics and Musculoskeletal Science (IOMS), Division of Surgery and Interventional Science, University College London, London, UK
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49
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Ho LC, Sigal IA, Jan NJ, Squires A, Tse Z, Wu EX, Kim SG, Schuman JS, Chan KC. Magic angle-enhanced MRI of fibrous microstructures in sclera and cornea with and without intraocular pressure loading. Invest Ophthalmol Vis Sci 2014; 55:5662-72. [PMID: 25103267 DOI: 10.1167/iovs.14-14561] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE The structure and biomechanics of the sclera and cornea are central to several eye diseases such as glaucoma and myopia. However, their roles remain unclear, partly because of limited noninvasive techniques to assess their fibrous microstructures globally, longitudinally, and quantitatively. We hypothesized that magic angle-enhanced magnetic resonance imaging (MRI) can reveal the structural details of the corneoscleral shell and their changes upon intraocular pressure (IOP) elevation. METHODS Seven ovine eyes were extracted and fixed at IOP = 50 mm Hg to mimic ocular hypertension, and another 11 eyes were unpressurized. The sclera and cornea were scanned at different angular orientations relative to the main magnetic field inside a 9.4-Tesla MRI scanner. Relative MRI signal intensities and intrinsic transverse relaxation times (T2 and T2*) were determined to quantify the magic angle effect on the corneoscleral shells. Three loaded and eight unloaded tendon samples were scanned as controls. RESULTS At magic angle, high-resolution MRI revealed distinct scleral and corneal lamellar fibers, and light/dark bands indicative of collagen fiber crimps in the sclera and tendon. Magic angle enhancement effect was the strongest in tendon and the least strong in cornea. Loaded sclera, cornea, and tendon possessed significantly higher T2 and T2* than unloaded tissues at magic angle. CONCLUSIONS Magic angle-enhanced MRI can detect ocular fibrous microstructures without contrast agents or coatings and can reveal their MR tissue property changes with IOP loading. This technique may open up new avenues for assessment of the biomechanical and biochemical properties of ocular tissues in aging and in diseases involving the corneoscleral shell.
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Affiliation(s)
- Leon C Ho
- NeuroImaging Laboratory, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - Ian A Sigal
- UPMC Eye Center, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - Ning-Jiun Jan
- UPMC Eye Center, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - Alexander Squires
- Medical Robotics Lab, College of Engineering, University of Georgia, Athens, Georgia, United States
| | - Zion Tse
- Medical Robotics Lab, College of Engineering, University of Georgia, Athens, Georgia, United States
| | - Ed X Wu
- Department of Electrical and Electronic Engineering, The University of Hong Kong, Pokfulam, Hong Kong, China
| | - Seong-Gi Kim
- NeuroImaging Laboratory, University of Pittsburgh, Pittsburgh, Pennsylvania, United States Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania, United States McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States Center for the Neural Basis of Cognition, University of Pittsburgh and Carnegie Mellon University, Pittsburgh, Pennsylvania, United States
| | - Joel S Schuman
- UPMC Eye Center, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania, United States Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - Kevin C Chan
- NeuroImaging Laboratory, University of Pittsburgh, Pittsburgh, Pennsylvania, United States UPMC Eye Center, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania, United States Center for the Neural Basis of Cognition, University of Pittsburgh and Carnegie Mellon University, Pittsburgh, Pennsylvania, United States
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50
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Waugh CM, Korff T, Fath F, Blazevich AJ. Effects of resistance training on tendon mechanical properties and rapid force production in prepubertal children. J Appl Physiol (1985) 2014; 117:257-66. [PMID: 24903920 DOI: 10.1152/japplphysiol.00325.2014] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Children develop lower levels of muscle force, and at slower rates, than adults. Although strength training in children is expected to reduce this differential, a synchronous adaptation in the tendon must be achieved to ensure forces continue to be transmitted to the skeleton with efficiency while minimizing the risk of strain-related tendon injury. We hypothesized that resistance training (RT) would alter tendon mechanical properties in children concomitantly with changes in force production characteristics. Twenty prepubertal children (age 8.9 ± 0.3 yr) were equally divided into control (nontraining) and experimental (training) groups. The training group completed a 10-wk RT intervention consisting of 2-3 sets of 8-15 plantar flexion contractions performed twice weekly on a recumbent calf-raise machine. Achilles tendon properties (cross-sectional area, elongation, stress, strain, stiffness, and Young's modulus), electromechanical delay (EMD; time between the onset of muscle activity and force), rate of force development (RFD; slope of the force-time curve), and rate of electromyographic (EMG) increase (REI; slope of the EMG time curve) were measured before and after RT. Tendon stiffness and Young's modulus increased significantly after RT in the experimental group only (∼29% and ∼25%, respectively); all other tendon properties were not significantly altered, although there were mean decreases in both peak tendon strain and strain at a given force level (14% and 24%, respectively; not significant) which may have implications for tendon injury risk and muscle fiber mechanics. A decrease of ∼13% in EMD was found after RT for the experimental group, which paralleled the increase in tendon stiffness (r = -0.59); however, RFD and REI were unchanged. The present data show that the Achilles tendon adapts to RT in prepubertal children and is paralleled by a change in EMD, although the magnitude of this change did not appear to be sufficient to influence RFD. These findings are of importance within the context of the efficiency and execution of movement.
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Affiliation(s)
- C M Waugh
- Centre for Sports Medicine and Human Performance, Brunel University, London, United Kingdom; and
| | - T Korff
- Centre for Sports Medicine and Human Performance, Brunel University, London, United Kingdom; and
| | - F Fath
- Centre for Sports Medicine and Human Performance, Brunel University, London, United Kingdom; and
| | - A J Blazevich
- Centre for Sports Medicine and Human Performance, Brunel University, London, United Kingdom; and Centre for Exercise and Sports Science Research, Edith Cowan University, Joondalup, Western Australia, Australia
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