From: Deciphering the pathogenesis of tendinopathy: a three-stages process
Injury | Healing responses | Failed Healing | Histopathological changes | Clinical presentation | Different manifestations |
---|---|---|---|---|---|
• Overuse • Previous traumatic injury • Xenobiotics • Pathogens | Inflammation | ⇒ | Sustained pro-inflammatory cytokines | • Pain • Mechanical weakness | • "Tendinitis" • Paratendinitis • Insertional tendinopathy • Overuse tendon injuries • Spontaneous rupture • Activity-related pain • Calcified tendinopathy |
Neovascularization | ⇒ | Hypervascularity | |||
Innervation | ⇒ | Increased neuropeptides and innervation | |||
Cell recruitment/apoptosis | ⇒ | Hypercellularity, increased apoptosis | |||
Matrix synthesis | ⇒ | Mucoid, lipoid, calcific degeneration | |||
Tenogenic differentiation/apoptosis | ⇒ | ||||
Matrix remodeling | ⇒ | Collagenolysis, tendon adhesion |