The influence of the mechanical environment on remodelling of the patellar tendon

St Mary's Hospital, Praed Street, Paddington, London W2 1NY, UK.
The Bone & Joint Journal (Impact Factor: 3.31). 05/2009; 91(4):557-64. DOI: 10.1302/0301-620X.91B4.21580
Source: PubMed


An understanding of the remodelling of tendon is crucial for the development of scientific methods of treatment and rehabilitation. This study tested the hypothesis that tendon adapts structurally in response to changes in functional loading. A novel model allowed manipulation of the mechanical environment of the patellar tendon in the presence of normal joint movement via the application of an adjustable external fixator mechanism between the patella and the tibia in sheep, while avoiding exposure of the patellar tendon itself. Stress shielding caused a significant reduction in the structural and material properties of stiffness (79%), ultimate load (69%), energy absorbed (61%), elastic modulus (76%) and ultimate stress (72%) of the tendon compared with controls. Compared with the material properties the structural properties exhibited better recovery after re-stressing with stiffness 97%, ultimate load 92%, energy absorbed 96%, elastic modulus 79% and ultimate stress 80%. The cross-sectional area of the re-stressed tendons was significantly greater than that of stress-shielded tendons. The remodelling phenomena exhibited in this study are consistent with a putative feedback mechanism under strain control. This study provides a basis from which to explore the interactions of tendon remodelling and mechanical environment.

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    • "or back pain are strongly related to moderately increased spinal loading arising from body weight ( Videman et al . , 2010 ) , occupation ( Videman et al . , 2006 ) , or leisure activities ( Videman et al . , 2007 ) , presumably because all skeletal tissues even - tually adapt to moderate and habitual levels of loading ( Skrzypiec et al . , 2007 ; Rumian et al . , 2009 ; Sugiyama et al . , 2012 ) . Cyclic loading of animal ten - dons causes deterioration if the loading is severe , and adaptation if it is moderate . ( Andarawis - Puri et al . , 2012 ) . In the words of Nietzsche : " What does not kill me makes me stronger ! ""
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