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Stimulation of tendon repair: mechanical loading, GDFs and platelets. A mini-review

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Abstract

The repair of subcutaneous tendon ruptures can be stimulated by a single application of one of several growth factors [e.g. platelet-derived growth factor (PDGF), transforming growth factor (TGF)-beta, insulin-like growth factor (IGF)-1, vascular endothelial growth factor (VEGF), bone morphogenetic proteins (BMPs) like growth differentiation factor (GDF)-5, -6, -7] or by a thrombocyte concentrate (PRP). The response to these measures is dependent on the mechanical microenvironment, which is crucial for repair. So far, almost all research has been limited to rodent models, mostly using the rat Achilles tendon. Ruptured human Achilles tendons appear to be mechanically loaded in spite of immobilisation. This suggests that the mechanical microenvironment might be favourable for the clinical use of growth factors or platelets for this indication. New methods to quantitate human Achilles tendon repair have been developed.

Résumé

La réparation de rupture tendineuse sous cutanée peut être améliorée par une simple application d’un ou de plusieurs facteurs de croissance (PDGF, TGF-beta, IGF-1, VEGF, BMPs, GDF like -5, -6, -7) ou par un concentré de plaquettes (PRP). Ce modèle a surtout été utilisé, au niveau du tendon d’Achille des rats. Cette étude nous montre que le micro environnement mécanique peut être amélioré par l’utilisation de facteurs de croissance et de concentrés de plaquettes. De nouvelles méthodes permettant de quantifier l’importance de la réparation du tendon d’Achille humain ont été développées.

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Acknowledgement

Dr. Olena Virchenko helped making Table 1.

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Correspondence to Per Aspenberg.

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Aspenberg, P. Stimulation of tendon repair: mechanical loading, GDFs and platelets. A mini-review. International Orthopaedics (SICO 31, 783–789 (2007). https://doi.org/10.1007/s00264-007-0398-6

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