Molecular Mechanisms of Tendon Healing and their Potential Clinical Applications: A Review of Recent Developments

Abstract

Tendon injuries are frequent and responsible for substantial morbidity both in sports and in the workplace. Tendon injuries posses an elevated morbidity percentage and is challenging to accomplish a satisfying prognosis with currently accessible management methods. Contemporary strategies utilized for tendon healing constantly result in the formation of fibrovascular scar tissue, wich substantially affects the biomechaniscs of the healed tendon. Furthermore, the related functional deficit declines over time with an augmented injury repetition risk. Tendinopathies are aching, impairing conditions that affect 25% of adults all over the world. In this article a narrative review of the literature on known general molecular mechanisms of tendon healing and their potential clinical apllications has been performed. Based on experimental and in vitro sudies, the most importan new possible therapeutic options for tendon healing include asperosaponin VI, hyaluronic acid, substance P inhibitor, tetranectin, platelet-rich plasma (PRP), platelet-derived growth factor, promethazine, milk fat globulin protein E8, SS-31 (elamipretide), tamoxifen, kartogenin (KGN)-PRP gel, and percutaneous electrolysis. Based on clinical studies, the most important new possible therapeutic options for tendon healing include acellular dermal matrix (ADM), sodium hyaluronate, augmentation with resorbable type I bovine collagen implant, and microfragmented adipose tissue (M-FATS). Although much progress has been made in understanding the molecular mechanisms of tendon healing, much remains to be understood about them. It is hoped that future research may help to fully or better understand these mechanisms, which will be very important to find new therapies to help improve the healing capacity of tendon injuries.