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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.
The existing epithelial cells can replicate, and, using the basement membrane as a guide, eventually bring the kidney back to normal. After regeneration is complete, the damage is undetectable, even microscopically. [citation needed] Healing must happen by repair in the case of injury to cells that are unable to regenerate (e.g. neurons).
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]
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 ...
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.
The rehabilitation is often long and demanding. The main reason is that it takes a long time for the cartilage cells to adapt and mature into repair tissue. Cartilage is a slow adapting substance. Where a muscle takes approximately 35 weeks to fully adapt itself, cartilage only undergoes 75% adaptation in 2 years.
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