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Various academic studies show that tendons can respond well to controlled loading, post-injury. [5] [6] Loading of a tendon results in up regulation of insulin-like growth factor, [7] [8] in addition to other cytokines and growth factors. [9] This up regulation results in proliferation at the cellular level and remodelling of the tendon matrix.
A variety of other molecules are involved in tendon repair and regeneration. There are five growth factors that have been shown to be significantly upregulated and active during tendon healing: insulin-like growth factor 1 (IGF-I), platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF), basic fibroblast growth factor ...
Healing must happen by repair in the case of injury to cells that are unable to regenerate (e.g. neurons). Also, damage to the collagen network (e.g. by enzymes or physical destruction), or its total collapse (as can happen in an infarct) cause healing to take place by repair. [citation needed]
The use of embryonic stem cells has also been applied to tendon repair. The embryonic stem cells were shown to have a better survival rate in the tendon as well as better migrating capabilities to reach all areas of damaged tendon. The overall repair quality was also higher, with better tendon architecture and collagen formed.
This is in contrast to wound healing, or partial regeneration, which involves closing up the injury site with some gradation of scar tissue. Some tissues such as skin, the vas deferens , and large organs including the liver can regrow quite readily, while others have been thought to have little or no capacity for regeneration following an injury.
Timing is important to wound healing. Critically, the timing of wound re-epithelialization can decide the outcome of the healing. [11] If the epithelization of tissue over a denuded area is slow, a scar will form over many weeks, or months; [12] [13] If the epithelization of a wounded area is fast, the healing will result in regeneration.
The usual risks of surgery are involved, including: infection, stiffness, death, suture reaction, failure of satisfactory healing, risks of anesthesia, phlebitis, pulmonary embolus, and persistent pain or weakness after the injury and repair. [citation needed] If the tendon rupture is a partial tear (without the two parts of the tendon being ...
Unlike the patellar ligament, the hamstring tendon's fixation to the bone can be affected by motion after surgery. Therefore, a brace is often used to immobilize the knee for one to two weeks. Evidence suggests that the hamstring tendon graft does as well, or nearly as well, as the patellar ligament graft in the long term. [10]
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