Figure: Schematic summarising the cellular and molecular features of chronic inflammation identified from cross-sectional assessments of functionally distinct tendons.
Achilles tendon disorders including tendinopathy and rupture are a common cause of musculoskeletal pain and disability. These injuries require prolonged rehabilitation and have a high frequency of recurrence.
In a study by Stephanie Dakin et al, entitled ImPAcT (Inflammation and Pain in Achilles Tendinopathy), scientists teamed up with the OxSport and John Radcliffe Trauma teams to investigate the cellular and molecular features of inflammation in patient biopsy samples of tendinopathic and ruptured Achilles.
The aim of the study was to investigate if energy storing tendons such as the Achilles shared common cellular and molecular inflammatory mechanisms with those previously identified in disease of positional shoulder tendons.
The study showed that chronic inflammation was a feature of both mid-portion Achilles tendinopathy and rupture. Tissue inflammation signatures differed in ruptured compared to non-ruptured Achilles, likely to be due to acute inflammation and increased vascularisation resulting from recent trauma.
The investigators concluded that whilst Achilles and rotator cuff tendons are functionally distinct, they share common cellular and molecular inflammatory disease mechanisms, including macrophage and stromal fibroblast activation (summarized below). Future research will focus on developing new therapeutic approaches to promote resolution of inflammation in chronic tendinopathy.
Read the full article in the British Journal of Sports Medicine:
- Chronic inflammation is a feature of Achilles tendinopathy and rupture: Stephanie G Dakin, Julia L Newton, Fernando O Martinez, Robert Hedley, Stephen Gwilym, Natasha Jones, Hamish AB Reid, Simon Wood, Graham Wells, Louise Appleton, Kim Wheway, Bridget Watkins, Andrew J Carr.