Tendon Growth & Repair

Question 1

Describe the structure of a tendon

Answer 1

Longitudinal tenocytes & Type 1 collagen fibres

• Collagen bundle covered by endotendon
• Fascicle covered by paratendon
• Tendon covered by epitendon

Question 2

Which layer of a tendon are blood vessels found in ?

Answer 2

Paratendon wrapped around the fascicles

Question 3

What’s found in a tendon sheath?

Answer 3

Vincula which connect to the tendon

Synovial lining & fluid for lubrication/nutrition

Question 4

What happens to tendons if you’re immobile?>

Answer 4

Lose water content and glycosaminoglycan conc –> strength loss

Question 5

What are some major types of tendon injury and an example

Answer 5

• Degeneration e.g. Intrasubstance mucoid degeneration of Achilles
• Inflammation e.g. De Quervains Stenosing Tenovaginitis in thumb
• Enthesiopathy e.g. Tennis elbow
• Avulsion
• Traction Apophysitis e.g. Osgood Schlatter’s
• Rupture e.g. common in achilles
• Laceration e.g. finger flexors

Question 6

How could you treat an avulsion?

Answer 6

Conservative

Mostly operative:
- Reattach tendon
- Fixation of bone fragment

Question 7

How do you confirm a ruptured achilles?

Answer 7

+ve Simmond’s Squeeze test
Palpable tender gap

Question 8

How can you treat a ruptured tendon conservatively

Answer 8

If the ends can be opposed:
- Mobilize (partial)
- Splint/cast (full)

Question 9

When would you treat a ruptured tendon surgically?

Answer 9

• Ends can’t be opposed
• High risk of rerupture
• High activity (e.g. sportsmen)