Scientists reveal new insights into tendon injury

March 1, 2011

Scientists have discovered how tendons – the fibrous tissue that connects muscle

to bone – become damaged through injury or the ageing process in what could lead

to new treatments for people with tendon problems.

The University of Manchester team, working with colleagues at Glasgow

University, have been investigating 'adhesions', which are a build up of

unwanted fibrous tissue on internal organs that have been damaged as a result of

surgery or injury.

Adhesions cause organs to stick together and are extremely painful and

distressing for patients, who often have to undergo surgery and rehabilitation.

The estimated cost of adhesions to the NHS is £100 million each year.

In this study, published in the journal PLoS One, the researchers wanted to

understand how tendon adhesions form, so examined the surface of healthy tendons

and discovered that they are covered by a thin layer of skin.

" Tendons attach our muscles to bone and are essential for movement, " said lead

researcher Professor Karl Kadler, from the Wellcome Trust Centre for Cell Matrix

Research in Manchester's Faculty of Life Sciences.

" In order to do this, tendons need to glide freely but when an adhesion forms

the tendon can no longer travel over the bone, which causes pain, stiffness and

reduced movement.

" We reasoned that the surface of tendons must contain a special cell that stops

adhesions from forming in healthy people. We discovered that the tendon is

actually covered by a thin layer of epithelial cells, which are usually found in

skin.

" Undamaged tendons do not form adhesions but when the tendon 'skin' is damaged,

the cells inside the tendon form an unwanted adhesion which begins to stick to

nearby tissues. "

The team were able to show that mice with defective cells at the surface of

their tendons appeared to have difficulty walking and spontaneously develop

tendon adhesions, even without surgery or injury.

Dr , from The University of Manchester and co-author on the paper,

added: " This study of tendon adhesions shows that the integrity of the surface

of a tissue is critical in preventing adhesions. Furthermore, the discovery of

this completely new layer of tendon cells changes the way we are thinking about

how tendons are made during embryonic development and maintained in adulthood.

Future research is aimed at finding ways of protecting the tendon epithelium in

older people and in athletes. "

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