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J Biomech Eng 2019 Apr 20. Epub 2019 Apr 20.

ASME Fellow, Department of Biomedical Engineering, Department of Mechanical Engineering, University of Delaware Newark, Delaware 19716.

Inelastic behaviors, such as softening, a progressive decrease in modulus before failure, occur in tendon and are important aspect in degeneration and tendinopathy. These inelastic behaviors are generally attributed to two potential mechanisms: plastic deformation and damage. However, it is not clear which is primarily responsible. Read More

J Sci Med Sport 2019 Apr 5. Epub 2019 Apr 5.

Department of Biological Systems Engineering, University of Nebraska-Lincoln, USA.

Objectives: Although expected, tendon adaptations in adolescent elite athletes have been underreported. Morphologically, adaptations may occur by an increase in collagen fiber density and/or organization. These characteristics can be captured using spatial frequency parameters extracted from ultrasound images. Read More

Korean J Pediatr 2019 Mar 15. Epub 2019 Mar 15.

Pediatric Allergy and Respiratory Center, Department of Pediatrics, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.

Mycoplasma pneumoniae pneumonia (MPP) has been generally susceptible to macrolides, however emergence of macrolide-resistant Mycoplasma pneumoniae pneumonia (MRMP) has made the treatment of MPP challenging. MRMP rapidly spread after 2000s, especially in the Eastern Asia. MRMPs are more common in children and adolescents than in adults, which is likely related to the frequent use of macrolides for treatments of MP infections in children. Read More

Clin J Sport Med 2019 Apr 8. Epub 2019 Apr 8.

The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts.

Objective: To analyze the characteristics of injuries sustained by young figure skaters who were evaluated at regional pediatric sports medicine clinics.

Design: Retrospective chart review (2003-2017).

Setting: Sports medicine clinics at a tertiary-level pediatric medical center. Read More

J Orthop Res 2019 Apr 12. Epub 2019 Apr 12.

Department of Biomedical Engineering, University of Delaware.

Tendinopathy, degeneration of tendon that leads to pain and dysfunction, is common in both sports and occupational settings, but multi-scale mechanisms for tendinopathy are still unknown. We recently showed that micro-scale sliding (shear) is responsible for both load transfer and damage mechanisms in rat tail tendon; however, rat tail tendon is a specialized non-load bearing tendon, and thus the load transfer and damage mechanisms are still unknown for load-bearing tendons. The objective of this study was to investigate the load transfer and damage mechanisms of load-bearing tendons using rat plantaris tendon. Read More

Ann Rheum Dis 2019 Apr 11. Epub 2019 Apr 11.

Department of Rheumatology, CHU Nantes, Nantes, France

Objective: Steroid injections are common after an ultrasound-guided puncture and lavage (UGPL) of calcific tendonitis of the rotator cuff. However, steroids may prevent calcification resorption and negatively affect tendon healing. Our study was designed to determine whether saline solution was non-inferior to steroids in the prevention of acute pain reactions in the week following UGPL. Read More

Med Sci Sports Exerc 2019 Apr 8. Epub 2019 Apr 8.

Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Canada.

Background: Tendinopathies are painful overuse injuries observed in athletes participating in jumping sports. These injuries are heavily dependent on the resulting strain from the applied mechanical load. Therefore, mechanisms to reduce tendon strain may represent a primary prevention strategy to reduce the incidence of tendinopathy. Read More

Biomed Rep 2019 Apr 13;10(4):238-244. Epub 2019 Mar 13.

Department of Medicine for Motor Organs, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan.

To evaluate the biological changes in tendons during the aging process, the present study examined the effect of aging on the tendon structure, distribution of collagen types I and III, and expression of tendon-associated genes, using flexor tendons in a mouse model. Histological assessment of the tendon structure and distribution of collagen types I and III were performed, and the expression of tendon-associated genes was evaluated in flexor digitorium longus tendons of young (8 weeks) and aged (78 weeks) female C57BL/6 mice. The results indicated that the Soslowsky score, based on the analysis of cellularity, fibroblastic changes, and collagen fiber orientation and disruption, was significantly increased, or worsened, in the tendons of the aged group compared with those in the young group. Read More

J Am Podiatr Med Assoc 2019 Jan;109(1):1-8

Background: Achilles insertional tendon pathology is a common condition affecting a broad range of patients. When conservative treatments are unsuccessful, the traditional open resection, debridement, and reattachment of the Achilles tendon is a variably reliable procedure with significant risk of morbidity. Fasciotomy and surgical tenotomy using ultrasound-guided percutaneous microresection is used on various tendons in the body, but the efficacy has not been examined specifically for the Achilles tendon. Read More

Ann Transl Med 2019 Feb;7(4):72

Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH, USA.

Overuse injuries of the extensor mechanism of the knee are common in both athletes and non-athletes and usually occur during activities associated with repetitive loading, stress, and knee extension. Numerous reports have been published describing extensor mechanism injuries in athletes, but there is a paucity of studies that focus on quadriceps tendinopathy in the non-athlete population. In addition, there is no universally accepted classification system for tendon pathology. Read More

Ann Transl Med 2019 Feb;7(4):71

Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio, USA.

Overuse injuries of the extensor mechanism of the knee are common in both athletes and non-athletes and usually occur during activities associated with repetitive loading, stress, and knee extension. Historically, they have been labeled as Jumper's knee due to the high prevalence seen in the athletic community. In many published reports, the name "patellar tendinopathy" is used to describe this disorder of the quadriceps tendon at the patellar insertion, and the names are often used interchangeably. Read More

Ann Transl Med 2019 Feb;7(4):70

Department of Orthopaedic Surgery, Lenox Hill Hospital, New York, NY, USA.

Soft tissue dysfunction can result from the degeneration of tissues as in the case of degenerative tendinopathy or from the build-up of problematic scar tissue, which can be the result of several aggravating factors, including overuse injuries, acute or chronic trauma, or as a result of surgery. This dysfunction often results in impaired movement, pain, and swelling of the affected area, which can lead to patient dissatisfaction and a lower quality of life. These soft tissue dysfunctions also have a marked economic impact. Read More

Br J Sports Med 2019 Apr 8. Epub 2019 Apr 8.

School of Physiotherapy, University of Notre Dame Australia, Fremantle, Western Australia, Australia.

Br J Sports Med 2019 Apr 8. Epub 2019 Apr 8.

School of Physiotherapy, University of Notre Dame Australia, Fremantle, Western Australia, Australia.

J Biomech 2019 Mar 30. Epub 2019 Mar 30.

Human Performance Laboratory, University of Calgary, AB, Canada; McCaig Institute for Bone and Joint Health, University of Calgary, AB, Canada. Electronic address:

The worldwide trajectory of increasing obesity rates is a major health problem precipitating a rise in the prevalence of a variety of co-morbidities and chronic diseases. Tendinopathy, in weight and non-weight bearing tendons, in individuals with overweight or obesity has been linked to metabolic dysfunction resulting from obesity. Exercise and dietary fibre supplementation (DFS) are common countermeasures to combat obesity and therefore it seems reasonable to assume that they might protect tendons from structural and mechanical damage in a diet-induced obesity (DIO) model. Read More

Arthroscopy 2019 Apr;35(4):1036-1041

Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A.

Purpose: To evaluate outcomes after biceps tenodesis performed in patients younger than 25 years, to evaluate reoperations and complications in this population, and to critically appraise return to preinjury level of play for this population.

Methods: Forty-five consecutive patients younger than 25 years underwent subpectoral biceps tenodesis for biceps tendinopathy or biceps-labral complex injuries including SLAP tears. Biceps tenodesis was performed using an interference screw technique. Read More

J Foot Ankle Res 2019 21;12:20. Epub 2019 Mar 21.

1Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria 3086 Australia.

Background: Mid-portion Achilles tendinopathy is a common musculoskeletal condition characterised by degeneration of the Achilles tendon, which causes pain and disability. Multiple non-surgical treatments have been advocated for this condition including calf muscle eccentric exercise and in-shoe heel lifts. Although adherence is challenging, there is evidence to suggest that calf muscle eccentric exercise is effective in decreasing pain and improving function in people with Achilles tendinopathy. Read More

Scand J Med Sci Sports 2019 Apr 3. Epub 2019 Apr 3.

Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

The purpose of this study was to investigate the relation between external and internal load and the response of the patellar tendon structure assessed with ultrasound tissue characterization (UTC) in elite male volleyball players during preseason. Eighteen players were followed over 7 weeks, measuring four load parameters during every training and match: volume (minutes played), rating of perceived exertion (RPE) (ranging from 6 to 20), weekly load (RPE*volume), and jump frequency (number of jumps). Patellar tendon structure was measured biweekly using UTC, which quantifies tendon matrix stability resulting in four different echo types (I-IV). Read More

Mil Med 2019 Apr 3. Epub 2019 Apr 3.

Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA 01760.

Introduction: The Special Forces Assessment and Selection (SFAS) is an extremely physically and mentally demanding 19- to 20-day course designed to determine whether Soldiers are qualified to enter the Special Forces Qualification Course. As a first step to understand medical problems during SFAS, this study examined injuries, illnesses, and activities associated with injuries during the course.

Materials And Methods: Medical events during the SFAS course were compiled from Sick Call Trackers (a log of medical encounters maintained by medical personnel in the field) and Chronology of Medical Care (Standard Form 600). Read More

Orthopade 2019 Apr 1. Epub 2019 Apr 1.

Department of Hand-foot and Microsurgery 2, The 2nd affiliated Hospital, Inner Mongolia Medical University, No. 1 Yingfang Street, 010030, Hyumin District, Hohhot, Inner Mongolia, China.

Background: The Achilles tendon is the coarsest tendon in the body. Achilles tendonitis is relatively common and its incidence is increasing.

Purpose: To evaluate the efficacy of platelet-rich plasma (PRP) injections for treating Achilles tendonitis. Read More

Knee Surg Sports Traumatol Arthrosc 2019 Apr 1. Epub 2019 Apr 1.

Department of Sports and Exercise Medicine, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.

Purpose: Changes in tendon structure are commonly seen in patients with unilateral achilles (AT) or patellar (PT) tendinopathy but might also be present on the asymptomatic side, indicating a higher risk for developing symptoms. The aim of this study is to compare tendon structure of the symptomatic side with the asymptomatic side in AT and PT patients and control subjects.

Methods: A total of 46 patients with unilateral AT (16 insertional and 30 midportion) and 38 with unilateral PT were included. Read More

J Sports Med Phys Fitness 2019 May;59(5):839-845

Department of Orthopedic Surgery, University Hospital Center Zagreb, School of Medicine, University of Zagreb, Zagreb, Croatia -

Plantaris muscle (lat. musculus plantaris) is a fusiform muscle of the superficial posterior leg compartment, characterized with a small muscle belly and very long and slender tendon. Many anatomical variations of plantaris muscle have been reported previously, including its inconstancy. Read More

Sci Rep 2019 Apr 1;9(1):5399. Epub 2019 Apr 1.

W.H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, 313 Ferst Dr NW, Atlanta, GA, 30332, USA.

Degradation of extracellular matrix (ECM) during tendinopathy is, in part, mediated by the collagenolytic cathepsin K (catK) and cathepsin L (catL), with a temporal component to their activity. The objective of this study was to determine how catK and catL act in concert or in conflict to degrade collagen and tendon ECM during tissue degeneration. To do so, type I collagen gels or ECM extracted from apolipoprotein E deficient mouse Achilles tendons were incubated with catK and catL either concurrently or sequentially, incubating catK first, then catL after a delayed time period. Read More

Semin Musculoskelet Radiol 2019 Apr 29;23(2):162-176. Epub 2019 Mar 29.

Department of Radiology, Northwestern University/Northwestern Memorial Hospital, Chicago, Illinois.

Hip arthroplasty is a common and largely successful surgical procedure, often used for the treatment of advanced osteoarthritis. Imaging plays a key role in routine postoperative imaging surveillance as well as the evaluation of post-arthroplasty pain. Radiographs are the first-line imaging modality and may be followed by computed tomography (CT), ultrasound, and/or magnetic resonance imaging (MRI). Read More

Gait Posture 2019 May 18;70:275-283. Epub 2019 Mar 18.

UCRISE, University of Canberra, University Drive, Bruce, ACT, Australia. Electronic address:

Objectives: There is considerable debate among clinicians as to whether sports tape can provide mechanical support and pain relief. People with greater trochanteric pain syndrome (GTPS) have increased adduction moment, adduction angle and pelvic obliquity, likely contributing to the continuation of the pathology. We aimed to see if Dynamic Tape could control these movements and reduce pain. Read More

Diabet Med 2019 Mar 28. Epub 2019 Mar 28.

Imperial College Healthcare NHS Trust, London.

Joint problems commonly occur in people with diabetes. Cheiroarthropathy affects the hands and results in painless limited finger joint extension, appearing to be associated with longer diabetes duration and the presence of microvascular complications. The prevalence of cheiroarthropathy seems to be falling, perhaps as a result of improvements in glycaemic management. Read More

J Orthop Res 2019 Mar 27. Epub 2019 Mar 27.

Harrington Laboratory for Molecular Orthopedics, Department of Orthopedic Surgery, University of Kansas Medical Center, 3901 Rainbow Boulevard, MS #3017, Kansas City 66160, Kansas.

Aging is the strongest risk factor for degenerative bone and joint diseases. Clinical therapies for age-related musculoskeletal disorders face significant challenges as their pathogenic mechanisms remain largely unclear. This review article focuses on the recent advances in the understanding of regulatory mechanisms of musculoskeletal aging and their clinical relevance. Read More

FASEB J 2019 Mar 27:fj201900196R. Epub 2019 Mar 27.

Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, Botnar Research Centre, Nuffield Orthopaedic Center, University of Oxford, Oxford, United Kingdom.

Resolution of inflammation is poorly understood in Achilles tendon disorders. Herein, we investigated the bioactive lipid mediator profiles of tendon-derived stromal cells isolated from patients with Achilles tendinopathy (AT) or Achilles rupture (AR) under baseline and IL-1β-stimulated conditions. We also determined whether incubating these cells with 2 of the mediators produced by tendon-derived stromal cells, 15-epi-LipoxinA (15-epi-LXA) or maresin (MaR)-1, moderated their proinflammatory phenotype. Read More

Orthop J Sports Med 2019 Mar 21;7(3):2325967119834284. Epub 2019 Mar 21.

The Research Centre of Movement Science, Department of Physical Therapy, University of Iceland, Reykjavik, Iceland.

Background: Eccentric exercises are the only conservative treatment that has shown good clinical results in studies of Achilles tendinopathy (AT), but success rates vary, indicating the need for alternative treatments. Soft tissue treatments are widely used for AT, but strong scientific evidence is lacking to support those treatments.

Purpose/hypotheses: This study aimed to determine whether pressure massage to the calf muscles is a useful treatment for AT and to compare this treatment versus an eccentric exercise protocol. Read More

Cureus 2018 Dec 27;10(12):e3783. Epub 2018 Dec 27.

Dermatology, San Diego Family Dermatology, San Diego, USA.

Tendon disorders include tenosynovitis or tendonitis, tendinosis, and tendon rupture. Tendinopathy associated with drug administration has been associated with the systemic or local administration of several medications. A 90-year-old man who developed toxic tendinopathy after receiving cephalexin 500 mg twice daily has been described. Read More

Nat Rev Rheumatol 2019 Mar 26. Epub 2019 Mar 26.

Nature Reviews Rheumatology, .

J Physiother 2019 Apr 23;65(2):107. Epub 2019 Mar 23.

Department of Physiotherapy, Oslo Metropolitan University, Norway.

J Physiother 2019 Apr 23;65(2):107. Epub 2019 Mar 23.

Department of Physiotherapy, Oslo Metropolitan University, Norway.

J Foot Ankle Surg 2019 Mar 23. Epub 2019 Mar 23.

Consultant, Sport & Exercise Medicine, Department of Sport and Exercise Medicine, University Hospitals of Leicester National Health Service Trust, Leicester, United Kingdom; Senior Clinical Academic Fellow, School for Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom; Consultant, Sport & Exercise Medicine, National Centre for Sport and Exercise Medicine-East Midlands, Loughborough, United Kingdom. Electronic address:

Achilles tendinopathy, both insertional and noninsertional, is a common cause of posterior ankle pain. Although the condition of most patients improves with simple conservative measures, a proportion will go on develop chronic symptoms. This study examines the outcomes of patients following extracorporeal shock wave therapy plus a home exercise program. Read More

Musculoskelet Sci Pract 2019 Mar 19;41:28-35. Epub 2019 Mar 19.

Research Group Diagnostics, Avans University of Applied Science, Hogeschoollaan 1, 4818 CR Breda, the Netherlands; Department of Family Practice, Erasmus Medical Centre, Wytemaweg 80, 3015 CN Rotterdam, the Netherlands.

Study Design: Prospective cohort study including patients with shoulder pain in primary care physiotherapy.

Background: There is an increased tendency to use diagnostic ultrasound to aid the diagnostic strategy and target treatment. It is a relatively cheap and accessible imaging technique but the implications for practice and patients are unknown. Read More

Skeletal Radiol 2019 Mar 21. Epub 2019 Mar 21.

Department of Radiology, UCLA Health System, Los Angeles, CA, USA.

Objective: To determine the clinical significance of T2 signal hyperintensity in the proximal patellar tendon seen on MRI of the knee.

Materials And Methods: MRIs of 100 patients who underwent MRI of the knee between 1 May 2018 and 15 July 2018 were retrospectively evaluated. All examinations were performed on 3-Tesla MRI scanners with a dedicated knee coil and in accordance with our institution's standard knee MRI protocol. Read More

Knee Surg Sports Traumatol Arthrosc 2019 Mar 21. Epub 2019 Mar 21.

Orthopädische Gemeinschaftspraxis Schützenmatt, Schützenmattstrasse 41, 4051, Basel, Switzerland.

Purpose: Chronic Achilles tendinopathy is one of the most common causes of malfunction and pain, which can lead to a significant reduction of the quality of life. The hypothesis of this study argues that autologous conditioned serum (i.e. Read More

Sports Med Open 2019 Mar 20;5(1):10. Epub 2019 Mar 20.

Health Services and Policy Research Group, University of Exeter Medical School, Exeter, UK.

Background: Lateral elbow tendinopathy (LET) is a common condition affecting adults. Although a lack of treatment consensus continues to prompt numerous effectiveness studies, there is a paucity of clear guidance on the choice of outcome measure. Our aim was to undertake a standardised evaluation of the available clinical rating systems that report patient-centred outcomes in LET. Read More

N Engl J Med 2019 Mar;380(12):e15

From St. Elizabeth's Medical Center, Brighton, MA (C.S.D.); Tufts University School of Medicine (C.S.D.), Beth Israel Deaconess Medical Center (C.C.S.), and Harvard Medical School (C.C.S.) - all in Boston; and St. Mary's Medical Center, San Francisco (W.K.W.).

J Am Vet Med Assoc 2019 Apr;254(7):852-858

Objective: To describe the use of non-contrast-enhanced CT to identify deep digital flexor (DDF) tendinopathy in horses with lameness attributed to pain in regions distal to the metatarsophalangeal or metacarpophalangeal joints.

Design: Retrospective case series.

Animals: 28 client-owned horses. Read More

Dose Response 2019 Jan-Mar;17(1):1559325819832143. Epub 2019 Mar 10.

Graduate Institute of Biomedical Engineering, Chang Gung University, Taoyuan.

Tendinopathy is a common painful musculoskeletal disorder treated by injection of analgesics and nonsteroidal anti-inflammatory drugs (NSAIDs), which are believed to have cytotoxicity toward tenocytes. Ascorbic acid is an antioxidant that promotes collagen biosynthesis and prevents free radical formation. It is believed to protect tenocytes from oxidative stress. Read More

Sci Rep 2019 Mar 18;9(1):4784. Epub 2019 Mar 18.

Department of Biomedical Engineering, National Taiwan University, Taipei, Taiwan.

Resulting from accumulative microtrauma, impaired healing and oxidative stress, tendinopathy is a debilitating and relentlessly deteriorating disease that greatly affects daily function and quality of life. Current therapy usually provides symptomatic relief only. Sufferers undergo repetitive and protracted treatment courses that rarely alter the disease process. Read More

Phys Ther Sport 2019 Mar 9;37:69-76. Epub 2019 Mar 9.

Department of Health Sciences, University of Leicester, United Kingdom.

Objectives: Determine how the strength and endurance of the plantar flexors are affected by Achilles tendinopathy and whether one muscle is more affected than another.

Design: Case control study.

Setting: University Laboratory. Read More

Acta Orthop Belg 2018 Dec;84(4):539-545

The aim is to report the long-term clinical results after pisiform excision in patients with refractory flexor carpi ulnaris (FCU) tendinopathy. We performed pisiform excision in 14 patients with recalcitrant FCU tendinopathy, who had failed conservative treatment. Nine patients were followed-up for more than 2 years. Read More

J Endocrinol Invest 2019 Mar 15. Epub 2019 Mar 15.

Division of Diagnostic and Interventional Radiology, IRCCS Rizzoli Orthopaedic Institute, Bologna, Italy.

Background: Hypothalamic-pituitary-adrenal axis (HPAA) suppression is the most common and dangerous, although often unrecognized and untreated, side effect of glucocorticoid administration. The risk and duration depend both on patient and treatment characteristics. High-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) currently represents the gold standard method to evaluate the metabolism of endogenous and exogenous steroids. Read More

Atheroscler Suppl 2019 Mar 29;36:6-11. Epub 2019 Jan 29.

Children's Hospital, Vilnius University Hospital Santaros Klinikos, Lithuania.

Background And Aims: Achilles tendon lesions have long been associated with genetic defects in lipid metabolism and increased risk of cardiovascular diseases (CVD). With this study we aimed to evaluate the usefulness of Achilles tendon ultrasonography in identifying people at greater risk among subjects with severe hypercholesterolemia (SH) in a high-risk population.

Methods: During the period of 2016-2017 a total of 213 participants were enrolled in this case-control study. Read More

Arthritis Res Ther 2019 Mar 13;21(1):74. Epub 2019 Mar 13.

Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Nuffield Orthopaedic Centre, Headington, OX3 7LD, UK.

Background: Tendon disease is a significant global healthcare burden whereby patients experience pain and disability; however, the mechanisms that underlie inflammation and pain are poorly understood. Herein, we investigated the role of prostaglandins as important mediators of inflammation and pain in tissues and cells derived from patients with tendinopathy.

Methods: We studied supraspinatus and Achilles tendon biopsies from symptomatic patients with tendinopathy or rupture. Read More

Pain Res Manag 2019 4;2019:2823401. Epub 2019 Feb 4.

Anesthesiologist, Kuang Tien General Hospital, No. 117, Shatian Road, Shalu District, Taichung City 433, Taiwan.

Objective: To compare the safety and efficacy of 2 transcutaneous stimulation techniques, transcutaneous pulsed radiofrequency (TPRF) versus transcutaneous electrical nerve stimulation (TENS), in chronic shoulder tendonitis.

Design: A prospective, randomized, and double-blind clinical trial.

Setting: Academic pain service of a city hospital. Read More