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Tissue Engineering Solutions for Tendon Repair

Tendon injuries range from acute traumatic ruptures and lacerations to chronic overuse injuries, such as tendinosis. Even with improved nonsurgical, surgical, and rehabilitation techniques, outcomes following tendon repair are inconsistent. Primary repair remains the standard of care. However, repaired tendon tissue rarely achieves functionality equal to that of the preinjured state. Poor results have been linked to alterations in cellular organization within the tendon that occur at the time of injury and throughout the early stages of healing. Enhanced understanding of the biology of tendon healing is needed to improve management and outcomes. The use of growth factors and mesenchymal stem cells and the development of biocompatible scaffolds could result in enhanced tendon healing and regeneration. Recent advances in tendon bioengineering may lead to improved management following tendon injury.

Rupture of the Achilles Tendon: Diagnosis and Management

Rupture of the Achilles tendon occurs in an estimated 18 per 100,000 persons, making it one of the most common tendon injuries. This injury is most frequently seen in middle-aged individuals, predominantly men, with a male-to-female ratio of approximately 12:1. Diagnosis of Achilles tendon rupture is initially missed in an estimated 20% to 25% of cases, because patients often continue to have active ankle plantar flexion due to the action of other ankle flexor muscles. The optimal treatment of Achilles tendon rupture remains controversial. Surgical treatment is usually recommended for healthy, active individuals with good healing potential. However, recent studies have shown comparable outcomes with nonsurgical treatment and an accelerated functional rehabilitation program.