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Electron microscope study of the advanced tendinopathy process of the long head of the biceps brachii tendon treated arthroscopically
Affiliations- Department of Orthopedic Surgery, Multidisciplinary Hospital, Poznanska street, 97, 88-100 Inowroclaw, Poland
- Department of Histology and Embryology, University Hospital No.1, Bydgoszcz, Poland
- Department of Orthopaedics, Orvit Clinic, Citomed Healthcare Centre, Torun, Poland
- Department of General Orthopaedics, Musculoskeletal Oncology and Trauma Surgery, Poznan University of Medical Sciences, Poznań, Poland
- Department of Clinical Pathomorphology, University Hospital No.1, Bydgoszcz, Poland
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Abstract
Background: The ultrastructural alterations related to tendinopathy have not been well described. Most studies on this subject have been conducted many years ago and focused on material from the Achilles tendon. It was demonstrated that various comorbidities can affect ultrastructural alterations in the advanced tendinopathy; however, there is very little data on ultrastructural morphology in tendinopathies related to mechanical overload as in case of the long head of the biceps brachii tendon (LHBT). The aim was to determine intermediate ultrastructural alterations in middle to severe grade the LHBT tendinopathy and to establish if they are different than those reported in the literature for other anatomical locations.
Materials and methods: In this study we examined the ultrastructure of a series of the LHBT fragments arthroscopically removed due to tendinopathy and investigated the morphology of tenocytes and collagen fibres in cases of the LHBT tendinopathy.
Results: In pathological samples tenocytes were randomly scattered, their shape was round and the shape of nuclei was also disrupted. The presence of apoptotic-like features in tenocytes’ nuclei was noted. All samples showed replacement of collagen fibrils by non-collagen extracellular matrix and diffuse collagen disorganisation.
Conclusions: It was demonstrated at ultrastructural level that the LHBT tendinopathy is not simply a wear and tear phenomenon, since chronic degeneration of the extracellular matrix and tenocytes were present, similarly as in tendinopathies, in other anatomical locations. (Folia Morphol 2018; 77, 2: 371–377)
Abstract
Background: The ultrastructural alterations related to tendinopathy have not been well described. Most studies on this subject have been conducted many years ago and focused on material from the Achilles tendon. It was demonstrated that various comorbidities can affect ultrastructural alterations in the advanced tendinopathy; however, there is very little data on ultrastructural morphology in tendinopathies related to mechanical overload as in case of the long head of the biceps brachii tendon (LHBT). The aim was to determine intermediate ultrastructural alterations in middle to severe grade the LHBT tendinopathy and to establish if they are different than those reported in the literature for other anatomical locations.
Materials and methods: In this study we examined the ultrastructure of a series of the LHBT fragments arthroscopically removed due to tendinopathy and investigated the morphology of tenocytes and collagen fibres in cases of the LHBT tendinopathy.
Results: In pathological samples tenocytes were randomly scattered, their shape was round and the shape of nuclei was also disrupted. The presence of apoptotic-like features in tenocytes’ nuclei was noted. All samples showed replacement of collagen fibrils by non-collagen extracellular matrix and diffuse collagen disorganisation.
Conclusions: It was demonstrated at ultrastructural level that the LHBT tendinopathy is not simply a wear and tear phenomenon, since chronic degeneration of the extracellular matrix and tenocytes were present, similarly as in tendinopathies, in other anatomical locations. (Folia Morphol 2018; 77, 2: 371–377)
Keywords
biceps tendon, long head of the biceps brachii tendon (LHBT), tendinopathy, transmission electron microscopy (TEM), ultrastructure
About this articleTitle
Electron microscope study of the advanced tendinopathy process of the long head of the biceps brachii tendon treated arthroscopically
Journal
Issue
Article type
Original article
Pages
371-377
Published online
2017-11-06
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2426
Article views/downloads
1311
DOI
Pubmed
Bibliographic record
Folia Morphol 2018;77(2):371-377.
Keywords
biceps tendon
long head of the biceps brachii tendon (LHBT)
tendinopathy
transmission electron microscopy (TEM)
ultrastructure
Authors
J. Zabrzyński
M. Gagat
Ł. Paczesny
Ł. Łapaj
D. Grzanka
References (18)- Abate M, Silbernagel KG, Siljeholm C, et al. Pathogenesis of tendinopathies: inflammation or degeneration? Arthritis Res Ther. 2009; 11(3): 235.
- Ahrens PM, Boileau P. The long head of biceps and associated tendinopathy. J Bone Joint Surg Br. 2007; 89(8): 1001–1009.
- Andarawis-Puri N, Flatow EL, Soslowsky LJ. Tendon basic science: Development, repair, regeneration, and healing. J Orthop Res. 2015; 33(6): 780–784.
- Ditsios K, Agathangelidis F, Boutsiadis A, et al. Long head of the biceps pathology combined with rotator cuff tears. Adv Orthop. 2012; 2012: 405472.
- Franchi M, Fini M, Quaranta M, et al. Crimp morphology in relaxed and stretched rat Achilles tendon. J Anat. 2007; 210(1): 1–7.
- Franchi M, Trirè A, Quaranta M, et al. Collagen structure of tendon relates to function. ScientificWorldJournal. 2007; 7: 404–420.
- Galliani I, Burattini S, Mariani AR, et al. Morpho-functional changes in human tendon tissue. Eur J Histochem. 2002; 46(1): 3–12.
- Grant WP, Sullivan R, Sonenshine DE, et al. Electron microscopic investigation of the effects of diabetes mellitus on the Achilles tendon. J Foot Ankle Surg. 1997; 36(4): 272–278; discussion 330.
- Hill AM, Hoerning EJ, Brook K, et al. Collagenous microstructure of the glenoid labrum and biceps anchor. J Anat. 2008; 212(6): 853–862.
- Joseph M, Maresh CM, McCarthy MB, et al. Histological and molecular analysis of the biceps tendon long head post-tenotomy. J Orthop Res. 2009; 27(10): 1379–1385.
- Kaux JF, Forthomme B, Goff CLe, et al. Current opinions on tendinopathy. J Sports Sci Med. 2011; 10(2): 238–253.
- Longo UG, Loppini M, Marineo G, et al. Tendinopathy of the tendon of the long head of the biceps. Sports Med Arthrosc Rev. 2011; 19(4): 321–332.
- Maffulli N, Longo UG, Franceschi F, et al. Movin and Bonar scores assess the same characteristics of tendon histology. Clin Orthop Relat Res. 2008; 466(7): 1605–1611.
- Pingel J, Lu Y, Starborg T, et al. 3-D ultrastructure and collagen composition of healthy and overloaded human tendon: evidence of tenocyte and matrix buckling. J Anat. 2014; 224(5): 548–555.
- Singaraju VM, Kang RW, Yanke AB, et al. Biceps tendinitis in chronic rotator cuff tears: a histologic perspective. J Shoulder Elbow Surg. 2008; 17(6): 898–904.
- Streit JJ, Shishani Y, Rodgers M, et al. Tendinopathy of the long head of the biceps tendon: histopathologic analysis of the extra-articular biceps tendon and tenosynovium. Open Access J Sports Med. 2015; 6: 63–70.
- Xu Y, Murrell GAC. The basic science of tendinopathy. Clin Orthop Relat Res. 2008; 466(7): 1528–1538.
- Zabrzyński J, Zabrzyńska A, Grzanka D. Tendinopathy – a disease of tendons. J Orthop Trauma Surg Related Res. 2016; 3(40): 24–30.
