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Bone and Tendon Graft Substitutes and Adjuncts - …
Tendons are strong; it would be possible to suspend a small car from an Achilles tendon. We can think of tendons and ligaments as bundles of fine filaments lying in a parallel arrangement and embedded in a sticky, jelly-like substance. The threads are, of course, the collagen fibres and the other material is mostly proteoglycans, large molecules with a certain amount of absorbent capacity. The collagen fibres are long and could possibly stretch along the whole length of the tendon without any joins. There are cells sparsely scattered here and there, and their function is to watch over the tendon material and replace it when necessary. This is a slow process, and how it works is not really known. When the tendon is not under traction, the collagen fibres lie in elongated spirals. This is seen as a wave-like pattern under the microscope (called crimp-pattern) and is caused by elastin fibres contracting the tendon.
Back to tendons and ligaments. If I were to sprain my foot I would take NSAIDs, even though they delay healing, just to reduce the pain and be able to start walking on my foot as soon as possible. On the other hand, I believe that the bad practice of treating top athletes almost continuously with NSAIDs definitely increases the risk of long-term problems.
Coordinated collagen and muscle protein synthesis in …
These results demonstrate two basic concepts: 1) in a confirmation of tissue structure function relationships, the stiffness and strength of healing ligaments correlates with the type and amount of collagen fibrils present, and 2) that mechanical stimulus has a significant affect on ligament structure.
The relationship between mobilization following repair and alterations of ligament structure and function is complex, depending on how long the ligament is immobilized following repair. In a study of Medial Collateral Ligament (MCL) repair, MCL were lacerated and then repaired. In one group, the MCL was not repaired, but it was immobilized. In the second group, the MCL was repaired and immobilized for three weeks while in the third group immoblization lasted for 6 weeks. Suprisingly, the group without repair that was immobilized early showed the best gain in strength over time. This reflected changes in the structural makeup of the ligament. The amount of type I vs. type III collagen (type III collagen is a type of collagen associated with wound healing) was closer to normal for the early mobilized ligament without repair. The change in strength over time is shown in the figure below (group 1 is the early mobilization without repair, group 2 is repair with 3 week immobilization and group 3 is repair with 6 week immobilization):
Type III collagen synthesis reached ..
Supplementation with 50 mL of Pure Gold Collagen on a daily basis for 60 days led to a noticeable reduction in skin dryness, wrinkles, and nasolabial fold depth.
where F1 represents the contribution of the isotropic ground matrix, F2 represents the contribution of the collagen fibers, and F3 represents the interaction between the collagen fibers and the matrix. The ligaments are also assumed to be incompressible due to the presence of water in the matrix. Recall that the general form of the 2nd Piola Kirchoff stress for an incompressible isotropic hyperelastic material is:
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have any impact on tendon/collagen strength
In arteries, collagen synthesis and degradation are associated with the progression of atherosclerotic disease and intimal hyperplasia following injury.
potential for de novo synthesis of collagen ..
Disturbances in the collagen turnover (synthesis and degradation) have been linked to inflammatory diseases including cardiovascular pathological syndromes.
in cellular metabolism and collagen synthesis; ..
A recent example of where QLV theory was applied to model the mechanical behavior of normal versus healing ligaments was provided by Abramowitch et al. (2004) using a coefficient fitting routine developed by Abramowitch and Wu (2004). They determined QLV parameters for both normal and healing Medical Collateral Ligaments (MCL) in a goal model for 12 weeks post-injury. The basic formulation again begins with the fundamental QLV theory representing stress as a reduced relaxation function times an instanttaneous elastic response e:
BME 332: Ligament/Tendon Structure-Function
Collagen synthesis is tightly regulated at several levels: synthesis of procollagens, suitable folding of polypeptides, secretion and cross-linking of mature fibers.
Collagen: What is it and what are its uses? - Health News
I have already described how mechanical loading is necessary to give the cells information about how the collagen should be oriented. This is what can generally be found in textbooks. However, loading is much more important than that. If we remove mechanical loading from our rat model, then only a thin, immature tissue is formed with a strength of 15-20% of what is otherwise normally seen. If we only moderately reduce the possibility for the rat to load the tendon, we get perhaps 30% of the strength found in the control animals. The callus is similar in size to the completely unloaded tendons, but the material properties are similar to the control tendons. This means that only a small amount of loading is required to get the right material properties, but more loading is required in order to get a thick callus.
Glossary | Linus Pauling Institute | Oregon State University
Yes indeed! First and foremost cyclooxygenase inhibitors (NSAIDs: Ibuprofen, Diclofenac, Celecoxib etc) have a clear inhibitory effect on tendon healing in our rat model. A normal dose for the first five days is enough to reduce strength by a third after a week. It takes a long time before it catches up with the untreated control tendons. Cyclooxygenase inhibitors are, of course, anti-inflammatory so these findings demonstrate that the early inflammation is necessary to give the healing process a good start. Even if we only have data from rats, it is likely in this case that the effects are the same in humans. Cyclooxygenase inhibitors have the same effect on the healing of fractures, and we know that this effect is similar in both rats and humans. There is a large randomised study that shows a great increase in the percentage of complications during healing in patients with high-energy fractures of long bones who are given NSAIDs. Yet, we often use NSAIDs to give pain relief with fractures. This is not ignorance, but a calculated risk. Common low energy fractures almost always heal well, and it may be worth a possible delay in healing so that good pain relief can be given without using morphine preparations. However, fractures where there is a risk of healing problems should definitely not be treated with NSAIDs.
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