Chondral metaplasia in calcific insertional tendinopathy of the Achilles tendon
Chondral metaplasia in calcific insertional tendinopathy of the Achilles tendon
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DOI：
10.1097/00042752-200607000-00008
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发表时间：
2006-07-01
影响因子：
2.7
通讯作者：
Barrass, Victoria
中科院分区：
文献类型：
--
作者：
Maffulli, Nicola;Reaper, Jacqueline;Barrass, Victoria
目的：为了确定从钙化性附着点跟腱病患者中采集的肌腱样本是否显示出愈合失败的特征，以及这些肌腱细胞是否在该区域产生了异常量的II型胶原。设计：比较实验室研究。设计：大学教学医院。患者：肌腱样本是从八个其他健康的男性个体中采集的（平均年龄47.5 ± 8.4岁，年龄38 - 60岁）和9例死于心血管事件的男性患者（平均年龄63.1 +/- 10.9岁）。干预措施：开放手术治疗钙化性跟腱病。主要结果测量：半定量组织化学，免疫组织化学和免疫细胞化学方法，以确定肌腱病肌腱是否与对照肌腱在形态上不同，以及是否产生异常类型的胶原蛋白。结果：腱细胞从钙化性跟腱病患者的肌腱表现出软骨化生，并产生异常高量的胶原蛋白II和III型。结论：改变生产的胶原蛋白可能是本研究中所描述的组织病理学改变的原因之一。钙化性跟腱附着点病变的区域承受了异常的负荷。这些钢筋束可能对拉力的抵抗力较小。进一步的研究应该调查为什么有些肌腱会发生这些变化。
Objective: To ascertain whether tendon samples harvested from patients with calcitic insertional Achilles tendinopathy showed features of failed healing response, and whether abnormal quantities of type II collagen had been produced in that area by these tenocytes.Design: Comparative laboratory study.Design: University teaching hospitals.Patients: Tendon samples were harvested from eight otherwise healthy male individuals (average age 47.5 +/- 8.4 years, range 38 to 60) who were operated for calcific insertional Achilles tendinopathy and from nine male patients who died of cardiovascular events (mean age 63.1 +/- 10.9 years) while in hospital.Interventions: Open surgery for calcific insertional Achilles tendinopathy.Main Outcome Measure: Semi-quantitative histochemical, immunohistochemical, and immunocytochemical methods to ascertain whether tendinopathic tendons were morphologically different from control tendons, and whether abnormal types of collagen were produced.Results: Tenocytes from tendons from patients with calcific insertional Achilles tendinopathy exhibit chondral metaplasia and produce abnormally high quantities of collagen type II an III.Conclusions: The altered production of collagen may be one reason for the histopathological alterations described in the present study. Areas of calcific insertional Achilles tendinopathy have been subjected to abnormal loads. These tendons may be less resistant to tensile forces. Further studies should investigate why some tendons undergo these changes.