Elevated fluid and glycosaminoglycan content in the Achilles tendon contribute to higher intratendinous pressures:Implications for Achilles tendinopathy  

作　　者：Lauren Pringels Gert-Jan Van Valckenborgh Patrick Segers Amelie Chevalier Hedwig Stepman Evi Wezenbeek Arne Burssens Luc Vanden Bossche 

机构地区：[1]Department of Physical and Rehabilitation Medicine,Ghent University Hospital,Ghent 9000,Belgium [2]Department of Rehabilitation Sciences and Physiotherapy,Ghent University,Ghent 9000,Belgium [3]Department of Electronics and Information Systems,Ghent University,Ghent 9000,Belgium [4]Department of Electromechanics,University of Antwerp,Antwerp 2020,Belgium [5]Department of Laboratory Medicine,Ghent University Hospital,Ghent 9000,Belgium [6]Department of Orthopedic Surgery,Ghent University Hospital,Ghent 9000,Belgium

出　　处：《Journal of Sport and Health Science》2024年第6期863-871,共9页运动与健康科学（英文）

基　　金：funded by Ghent University Hospital(FIKO21/TYPE2/013)。

摘　　要：Background:Tendinopathy alters the compositional properties of the Achilles tendon by increasing fluid and glycosaminoglycan content.It has been speculated that these changes may affect intratendinous pressure,but the extent of this relationship remains unclear.Therefore,we aimed to investigate the impact of elevated fluid and glycosaminoglycan content on Achilles tendon intratendinous pressure and to determine whether hyaluronidase(HYAL) therapy can intervene in this potential relationship.Methods:Twenty paired fresh-frozen cadaveric Achilles tendons were mounted in a tensile-testing machine and loaded up to 5% strain.Intratendinous resting(at 0% strain) and dynamic pressure(at 5% strain) were assessed using the microcapillary infusion technique.First,intratendinous pressure was measured under native conditions before and after infusion of 2 mL physiological saline.Next,80 mg of glycosaminoglycans were administered bilaterally to the paired tendons.The right tendons were additionally treated with 1500 units of HYAL.Finally,both groups were retested,and the glycosaminoglycan content was analyzed.Results:It was found that both elevated fluid and glycosaminoglycan content resulted in higher intratendinous resting and dynamic pressures(p <0.001).HYAL treatment induced a 2.3-fold reduction in glycosaminoglycan content(p=0.002) and restored intratendinous pressures.Conclusion:The results of this study demonstrated that elevated fluid and glycosaminoglycan content in Achilles tendinopathy contribute to increased intratendinous re sting and dynamic pressures,which can be explained by the associated increased volume and reduced permeability of the tendon matrix,respectively.HYAL degrades glycosaminoglycans sufficiently to lower intratendinous pressures and may,therefore,serve as a promising treatment.

关 键 词：Achilles tendon Achilles tendinopathy Intratendinous pressure GLYCOSAMINOGLYCANS Tendon fluid 

分 类 号：R686.1[医药卫生—骨科学]