VEGF Expression in Patellar Tendinopathy: a Preliminary Study

Overview

Journal Clin Orthop Relat Res

Publisher Wolters Kluwer

Specialty Orthopedics

Date 2008 May 7

PMID 18459027

Citations 26

Authors

Alexander Scott

Oystein Lian

Roald Bahr

David A Hart

Vincent Duronio

Affiliations

Soon will be listed here.

Abstract

Vascular function and angiogenesis are regulated by vascular endothelial growth factor-A (VEGF). The purpose of this preliminary study was to address the following questions: Is VEGF expression in the patellar tendon more prevalent in patients with patellar tendinopathy than in individuals with normal, pain-free patellar tendons? Which cell populations express VEGF in normal and tendinopathic tendon? Is there a difference in symptom duration between VEGF+ and VEGF- tendons? We collected patellar tendon tissue from 22 patients undergoing open débridement of the patellar tendon and from 10 patients undergoing intramedullary nailing of the tibia. VEGF expression was assessed immunohistochemically. Relevant inflammatory and repair cell types were immunolabeled. VEGF expression was absent from control tendons, but was present in a subset of patients with histopathological evidence of angiofibroblastic tendinosis. VEGF was expressed in the intimal layer of tendon vessels, but was absent in other cell types. Patients demonstrating VEGF expression in the patellar tendon had a shorter symptom duration (12 +/- 7.8 months) than patients with no detectable VEGF (32.8 +/- 23.5 months). VEGF may contribute to the vascular hyperplasia that is a cardinal feature of symptomatic tendinosis, particularly in cases with more recent onset.

Citing Articles

Patellar tendinopathy: an overview of prevalence, risk factors, screening, diagnosis, treatment and prevention.

Theodorou A, Komnos G, Hantes M Arch Orthop Trauma Surg. 2023; 143(11):6695-6705.

PMID: 37542006 PMC: 10541843. DOI: 10.1007/s00402-023-04998-5.

Optimizing repair of tendon ruptures and chronic tendinopathies: Integrating the use of biomarkers with biological interventions to improve patient outcomes and clinical trial design.

Hart D, Ahmed A, Ackermann P Front Sports Act Living. 2023; 4:1081129.

PMID: 36685063 PMC: 9853460. DOI: 10.3389/fspor.2022.1081129.

The Role of Vascular Endothelial Growth Factor in Tendon Healing.

Liu X, Zhu B, Li Y, Liu X, Guo S, Wang C Front Physiol. 2021; 12:766080.

PMID: 34777022 PMC: 8579915. DOI: 10.3389/fphys.2021.766080.

Dehydrated human amniotic membrane regulates tenocyte expression and angiogenesis in vitro: Implications for a therapeutic treatment of tendinopathy.

Moreno S, Massee M, Koob T J Biomed Mater Res B Appl Biomater. 2021; 110(4):731-742.

PMID: 34611976 PMC: 9292862. DOI: 10.1002/jbm.b.34951.

The Evaluation of Exogenous Melatonin Administration in Supraspinatus Overuse Tendinopathy in an Experimental Rat Model.

Kocadal O, Pepe M, Akyurek N, Gunes Z, Surer H, Aksahin E Clin Shoulder Elb. 2020; 22(2):79-86.

PMID: 33330199 PMC: 7714296. DOI: 10.5397/cise.2019.22.2.79.

References

Jarvinen T, Kannus P, Maffulli N, Khan K . Achilles tendon disorders: etiology and epidemiology. Foot Ankle Clin. 2005; 10(2):255-66. DOI: 10.1016/j.fcl.2005.01.013. View

Coleman B, Khan K, Maffulli N, Cook J, Wark J . Studies of surgical outcome after patellar tendinopathy: clinical significance of methodological deficiencies and guidelines for future studies. Victorian Institute of Sport Tendon Study Group. Scand J Med Sci Sports. 2000; 10(1):2-11. DOI: 10.1034/j.1600-0838.2000.010001002.x. View

Boyer M, Watson J, Lou J, Manske P, Gelberman R, Cai S . Quantitative variation in vascular endothelial growth factor mRNA expression during early flexor tendon healing: an investigation in a canine model. J Orthop Res. 2001; 19(5):869-72. DOI: 10.1016/S0736-0266(01)00017-1. View

Martinez-Silvestrini J, Newcomer K, Gay R, Schaefer M, Kortebein P, Arendt K . Chronic lateral epicondylitis: comparative effectiveness of a home exercise program including stretching alone versus stretching supplemented with eccentric or concentric strengthening. J Hand Ther. 2005; 18(4):411-9, quiz 420. DOI: 10.1197/j.jht.2005.07.007. View

Molloy T, Wang Y, Murrell G . The roles of growth factors in tendon and ligament healing. Sports Med. 2003; 33(5):381-94. DOI: 10.2165/00007256-200333050-00004. View

Yoshikawa T, Tohyama H, Enomoto H, Matsumoto H, Toyama Y, Yasuda K . Expression of vascular endothelial growth factor and angiogenesis in patellar tendon grafts in the early phase after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 2006; 14(9):804-10. DOI: 10.1007/s00167-006-0051-8. View

Bisset L, Paungmali A, Vicenzino B, Beller E . A systematic review and meta-analysis of clinical trials on physical interventions for lateral epicondylalgia. Br J Sports Med. 2005; 39(7):411-22. PMC: 1725258. DOI: 10.1136/bjsm.2004.016170. View

Young M, Cook J, Purdam C, Kiss Z, Alfredson H . Eccentric decline squat protocol offers superior results at 12 months compared with traditional eccentric protocol for patellar tendinopathy in volleyball players. Br J Sports Med. 2005; 39(2):102-5. PMC: 1725109. DOI: 10.1136/bjsm.2003.010587. View

Rees J, Wilson A, Wolman R . Current concepts in the management of tendon disorders. Rheumatology (Oxford). 2006; 45(5):508-21. DOI: 10.1093/rheumatology/kel046. View

10.

Alfredson H, Ohberg L, Forsgren S . Is vasculo-neural ingrowth the cause of pain in chronic Achilles tendinosis? An investigation using ultrasonography and colour Doppler, immunohistochemistry, and diagnostic injections. Knee Surg Sports Traumatol Arthrosc. 2003; 11(5):334-8. DOI: 10.1007/s00167-003-0391-6. View

11.

Rolf C, Fu B, Pau A, Wang W, Chan B . Increased cell proliferation and associated expression of PDGFRbeta causing hypercellularity in patellar tendinosis. Rheumatology (Oxford). 2001; 40(3):256-61. DOI: 10.1093/rheumatology/40.3.256. View

12.

Zanetti M, Metzdorf A, Kundert H, Zollinger H, Vienne P, Seifert B . Achilles tendons: clinical relevance of neovascularization diagnosed with power Doppler US. Radiology. 2003; 227(2):556-60. DOI: 10.1148/radiol.2272012069. View

13.

Alfredson H, Lorentzon M, Backman S, Backman A, Lerner U . cDNA-arrays and real-time quantitative PCR techniques in the investigation of chronic Achilles tendinosis. J Orthop Res. 2003; 21(6):970-5. DOI: 10.1016/S0736-0266(03)00107-4. View

14.

Yuan J, Murrell G, Wei A, Wang M . Apoptosis in rotator cuff tendonopathy. J Orthop Res. 2002; 20(6):1372-9. DOI: 10.1016/S0736-0266(02)00075-X. View

15.

Matthews T, Hand G, Rees J, Athanasou N, Carr A . Pathology of the torn rotator cuff tendon. Reduction in potential for repair as tear size increases. J Bone Joint Surg Br. 2006; 88(4):489-95. DOI: 10.1302/0301-620X.88B4.16845. View

16.

Khan K, Cook J, Bonar F, Harcourt P, Astrom M . Histopathology of common tendinopathies. Update and implications for clinical management. Sports Med. 1999; 27(6):393-408. DOI: 10.2165/00007256-199927060-00004. View

17.

Danielson P, Alfredson H, Forsgren S . Distribution of general (PGP 9.5) and sensory (substance P/CGRP) innervations in the human patellar tendon. Knee Surg Sports Traumatol Arthrosc. 2005; 14(2):125-32. DOI: 10.1007/s00167-005-0636-7. View

18.

Vos R, Weir A, Cobben L, Tol J . The value of power Doppler ultrasonography in Achilles tendinopathy: a prospective study. Am J Sports Med. 2007; 35(10):1696-701. DOI: 10.1177/0363546507303116. View

19.

Kannus P, Jozsa L . Histopathological changes preceding spontaneous rupture of a tendon. A controlled study of 891 patients. J Bone Joint Surg Am. 1991; 73(10):1507-25. View

20.

Scott A, Lian O, Bahr R, Hart D, Duronio V, Khan K . Increased mast cell numbers in human patellar tendinosis: correlation with symptom duration and vascular hyperplasia. Br J Sports Med. 2008; 42(9):753-7. DOI: 10.1136/bjsm.2007.040212. View