Regenerative medicine may treat chronic tendinosis, which is a type of soft tissue injury affecting a tendon. Tendon injuries include:
- Tendinopathy: this is an umbrella term used to describe any problem involving a tendon.
- Tendon tears: this is a rupture of a tendon and is an acute process.
- Tendinitis: refers to tendon inflammation; a non-specific term.
- Tendinosis: refers to a noninflammatory degeneration of the tendon collagen, often in response to chronic overuse and/or aging, or improper healing of an older acute injury (e.g. a tear).
In acute tendon injuries, bleeding and inflammation significantly lead to pain and reduced functionality. Tendinosis is distinguished by minimal inflammation, but this makes tendinosis more difficult to treat. This is because inflammation facilitates tissue repair, attracting growth and healing factors to the damaged tissue.
Chronic tendinosis is marked by persistent pain and thickening of the tendon, commonly arising from excessive use. Typically presenting in the chronic stage, these tendinopathies exhibit symptoms lasting over three months.
Pathophysiology
Underlying most cases of tendinopathy is an aberrant healing response within the tendon. In addition to minimal inflammation, tendinosis is characterized by changes in tendon structure that mainly reflect scarring and a healing response. These features include areas of fibroblast proliferation, the presence of smaller and less organized collagen fibres, and neovascularization/angiogenesis.
Risk Factors
Increased age and overall volume of tendon load pose the greatest risks for developing chronic tendinosis. Others include poor movement biomechanics, obesity, and prior injury.
Approaches to Treatment
Conservative treatments include modifying activities, pain management through NSAIDs or acetaminophen, and strength training with eccentric loading. Fenestration of the tendon to increase blood flow is another option as it increases inflammation to stimulate the body’s healing response but is extremely painful and responses are variable.
Corticosteroids are effective in reducing pain but carry risks like speeding up osteoarthritis and weakening tendons. Shock wave therapy currently does not have solid evidence supporting its use. Surgery is a last resort due to long wait times, risks, and extensive rehabilitation.
Eterna Treatment Options
Eterna uses cutting-edge technologies aimed at restoring tendon strength and function using the body’s own healing factors. Treatment options include platelet-rich plasma (PRP), which can stimulate inflammation and healing; stem cells, particularly mesenchymal stem cells (MSCs), which can normalize inflamed cartilage and reduce pain signalling by inhibiting the expression of calcitonin gene-related peptide (CGRP); and exosomes, vesicles secreted by MSCs that mediating intercellular communication and can regenerate cartilage and decrease inflammation. PRP, MSCs, and exosomes can be made to overexpress growth factors naturally occurring in the body that stimulate healing. These growth factors include BDNF, which promotes survival and growth of neurons; EGF, which stimulates proliferation of numerous cell lines; VEGF, which stimulates the formation of new blood vessels; and IL-RA, which selectively inhibits the inflammatory actions of IL-1. Incorporating these advanced therapies, Eterna offers a comprehensive approach to enhancing tendon strength and function, harnessing the body’s innate healing mechanisms for optimal recovery.
