The Role of Mechanical Loading in Tendon Development, Maintenance, Injury, and Repair

Overview

Journal J Bone Joint Surg Am

Specialties General Surgery
Orthopedics

Date 2013 Sep 6

PMID 24005204

Citations 90

Authors

Marc T Galloway

Andrea L Lalley

Jason T Shearn

Affiliations

Soon will be listed here.

Abstract

Tendon injuries often result from excessive or insufficient mechanical loading, impairing the ability of the local tendon cell population to maintain normal tendon function. The resident cell population composing tendon tissue is mechanosensitive, given that the cells are able to alter the extracellular matrix in response to modifications of the local loading environment. Natural tendon healing is insufficient, characterized by improper collagen fibril diameter formation, collagen fibril distribution, and overall fibril misalignment. Current tendon repair rehabilitation protocols focus on implementing early, well-controlled eccentric loading exercises to improve repair outcome. Tissue engineers look toward incorporating mechanical loading regimens to precondition cell populations for the creation of improved biological augmentations for tendon repair.

Citing Articles

Evaluation of Hand Function Using Relative Motion Extension Concept (with or Without Night Wrist Orthosis) or Dynamic Extension Orthosis for Extensor Tendon Injuries in Zones 4-6-A Randomized Controlled Trial.

Bojnec V, Vidmar J, Suznik Z, Oroz Koprivnik A, Spes Skrlec M, Frangez M Life (Basel). 2025; 15(2).

PMID: 40003659 PMC: 11856411. DOI: 10.3390/life15020249.

Tendon-targeted knockout of collagen XI disrupts patellar and Achilles tendon structure and mechanical properties during murine postnatal development.

Cohen J, Fung A, Stein M, Darrieutort-Laffite C, Weiss S, Shetye S Connect Tissue Res. 2024; 65(6):497-510.

PMID: 39620714 PMC: 11759649. DOI: 10.1080/03008207.2024.2432324.

Loss of drives impairments in tendon structure and function.

Adjei-Sowah E, Lecaj E, Adhikari N, Sensini C, Nichols A, Buckley M bioRxiv. 2024; .

PMID: 39605598 PMC: 11601365. DOI: 10.1101/2024.11.14.623674.

A Tympanic Piezo-Bioreactor Modulates Ion Channel-Associated Mechanosignaling to Stabilize Phenotype and Promote Tenogenesis in Human Tendon-Derived Cells.

Fernandez-Yague M, Palma M, Tofail S, Duffy M, Quinlan L, Dalby M Adv Sci (Weinh). 2024; 11(45):e2405711.

PMID: 39439240 PMC: 11615817. DOI: 10.1002/advs.202405711.

Transcriptome-Optimized Hydrogel Design of a Stem Cell Niche for Enhanced Tendon Regeneration.

Zhang W, Rao Y, Wong S, Wu Y, Zhang Y, Yang R Adv Mater. 2024; 37(2):e2313722.

PMID: 39417770 PMC: 11733723. DOI: 10.1002/adma.202313722.

References

HENDERSON J, Carter D . Mechanical induction in limb morphogenesis: the role of growth-generated strains and pressures. Bone. 2003; 31(6):645-53. DOI: 10.1016/s8756-3282(02)00911-0. View

Maganaris C, Narici M, Almekinders L, Maffulli N . Biomechanics and pathophysiology of overuse tendon injuries: ideas on insertional tendinopathy. Sports Med. 2004; 34(14):1005-17. DOI: 10.2165/00007256-200434140-00005. View

Magnusson S, Narici M, Maganaris C, Kjaer M . Human tendon behaviour and adaptation, in vivo. J Physiol. 2007; 586(1):71-81. PMC: 2375561. DOI: 10.1113/jphysiol.2007.139105. View

Rees J, Lichtwark G, Wolman R, Wilson A . The mechanism for efficacy of eccentric loading in Achilles tendon injury; an in vivo study in humans. Rheumatology (Oxford). 2008; 47(10):1493-7. DOI: 10.1093/rheumatology/ken262. View

Suchak A, Bostick G, Beaupre L, Durand D, Jomha N . The influence of early weight-bearing compared with non-weight-bearing after surgical repair of the Achilles tendon. J Bone Joint Surg Am. 2008; 90(9):1876-83. DOI: 10.2106/JBJS.G.01242. View

Thien T, Becker J, Theis J . Rehabilitation after surgery for flexor tendon injuries in the hand. Cochrane Database Syst Rev. 2004; (4):CD003979. DOI: 10.1002/14651858.CD003979.pub2. View

Rigozzi S, Muller R, Snedeker J . Local strain measurement reveals a varied regional dependence of tensile tendon mechanics on glycosaminoglycan content. J Biomech. 2009; 42(10):1547-1552. DOI: 10.1016/j.jbiomech.2009.03.031. View

Shearn J, Juncosa-Melvin N, Boivin G, Galloway M, Goodwin W, Gooch C . Mechanical stimulation of tendon tissue engineered constructs: effects on construct stiffness, repair biomechanics, and their correlation. J Biomech Eng. 2007; 129(6):848-54. DOI: 10.1115/1.2800769. View

Yasuda T, Kinoshita M, Abe M, Shibayama Y . Unfavorable effect of knee immobilization on Achilles tendon healing in rabbits. Acta Orthop Scand. 2000; 71(1):69-73. DOI: 10.1080/00016470052943937 . View

10.

Thomopoulos S, Zampiakis E, Das R, Silva M, Gelberman R . The effect of muscle loading on flexor tendon-to-bone healing in a canine model. J Orthop Res. 2008; 26(12):1611-7. PMC: 2601721. DOI: 10.1002/jor.20689. View

11.

Nowlan N, Murphy P, Prendergast P . Mechanobiology of embryonic limb development. Ann N Y Acad Sci. 2007; 1101:389-411. DOI: 10.1196/annals.1389.003. View

12.

Egerbacher M, Arnoczky S, Caballero O, Lavagnino M, Gardner K . Loss of homeostatic tension induces apoptosis in tendon cells: an in vitro study. Clin Orthop Relat Res. 2008; 466(7):1562-8. PMC: 2505255. DOI: 10.1007/s11999-008-0274-8. View

13.

Vogel H . Species differences of elastic and collagenous tissue--influence of maturation and age. Mech Ageing Dev. 1991; 57(1):15-24. DOI: 10.1016/0047-6374(91)90021-q. View

14.

Speck M, Klaue K . Early full weightbearing and functional treatment after surgical repair of acute achilles tendon rupture. Am J Sports Med. 1998; 26(6):789-93. DOI: 10.1177/03635465980260060901. View

15.

Malaviya P, Butler D, Korvick D, Proch F . In vivo tendon forces correlate with activity level and remain bounded: evidence in a rabbit flexor tendon model. J Biomech. 1999; 31(11):1043-9. DOI: 10.1016/s0021-9290(98)00123-7. View

16.

Joshi S, Webb K . Variation of cyclic strain parameters regulates development of elastic modulus in fibroblast/substrate constructs. J Orthop Res. 2008; 26(8):1105-13. DOI: 10.1002/jor.20626. View

17.

Flynn B, Bhole A, Saeidi N, Liles M, DiMarzio C, Ruberti J . Mechanical strain stabilizes reconstituted collagen fibrils against enzymatic degradation by mammalian collagenase matrix metalloproteinase 8 (MMP-8). PLoS One. 2010; 5(8):e12337. PMC: 2925882. DOI: 10.1371/journal.pone.0012337. View

18.

Zhang G . Evaluating the viscoelastic properties of biological tissues in a new way. J Musculoskelet Neuronal Interact. 2005; 5(1):85-90. View

19.

Heinemeier K, Langberg H, Olesen J, Kjaer M . Role of TGF-beta1 in relation to exercise-induced type I collagen synthesis in human tendinous tissue. J Appl Physiol (1985). 2003; 95(6):2390-7. DOI: 10.1152/japplphysiol.00403.2003. View

20.

Nakama L, King K, Abrahamsson S, Rempel D . Evidence of tendon microtears due to cyclical loading in an in vivo tendinopathy model. J Orthop Res. 2005; 23(5):1199-205. DOI: 10.1016/j.orthres.2005.03.006. View