Advancing Tendon Research Worldwide

About the Section

The ORS Tendon Section was launched in August 2016 by the organizers of the Tendon/Ligament RIG and the ORS. This section will promote and provide an interactive forum for education, collaboration, professional development, and strengthen scientific exchange in the ORS membership and tendon research community.

Background and importance to musculoskeletal research

Tendon disorders and injuries are common and lead to significant disability, pain, healthcare cost, and lost productivity. A wide range of injury mechanisms exist leading to tendinopathy or tendon rupture. Tears can occur in healthy tendons that are acutely overloaded (e.g., during a high speed or high impact event) or lacerated (e.g., a knife injury). Tendinitis or tendinosis can occur in tendons exposed to overuse conditions (e.g., an elite swimmer’s training regimen) or intrinsic tissue degeneration (e.g., age-related degeneration). The healing potential of a torn or pathologic tendon varies depending on its mechanism of injury as well as anatomic location (e.g., Achilles vs. rotator cuff) and local environment (e.g., intrasynovial vs. extrasynovial). Re-tear rates after surgical repair of some tendons such as those in the rotator cuff can be as high as 20-70%, while others appear to heal with relatively high rates of success, at least in the short-term. It should be appreciated then that our consideration of “tendon research” captures at least three clinically important tendons (Achilles, rotator cuff, flexor), each with unique injury mechanisms, anatomic location, local environments, and clinical challenges.

Despite the prevalence of tendon injuries and the well-appreciated spectrum of clinical challenges in their diagnosis and treatment, significant advancement in the field as a whole has arguably been hindered by an incomplete understanding of the fundamental biology of tendon development, signal transduction, mechanotransduction, and basic mechanisms underlying tendon pathogenesis and healing. Furthermore, current animal models of some tendon injuries and repair lack many of the anatomic, biologic and biomechanical features of human tenopathic conditions, making the translation of therapeutics or interventions aimed at improving tendon repair difficult to interrogate pre-clinically for those conditions. As well, current clinical diagnostic tools for tendons, such as imaging studies and patient-oriented questionnaires, lack the granularity needed to thoroughly understand the natural history of chronic tendon disorders, or to rigorously assess the success of their treatments, in human patients. Hence, in the tendon research field as whole, there remains a need for advancement at all levels of the spectrum from basic to clinical science.

Most important research topics/questions currently in this area

  • Investigate the fundamental biology of tendon development
  • Investigate molecular mechanisms controlling growth and differentiation of tendon cells
  • Identify cellular processes that facilitate repair and regeneration of tendon
  • Study the effect of metabolism on basic cellular processes of tendon cells
  • Identify cellular markers of tendon cells
  • Explore regulation, expression, and role of cytokines in tendon cell biology
  • Investigate the role of mechanical forces and other physical cues in tendon development, health, and disease
  • Improve animal models for tendon research and develop a consensus around best animal models for certain conditions and also which conditions cannot be modeled in a clinically meaningful way in an animal model.
  • Investigate a genetic basis for tendon disorders and/or poor healing
  • Translate the basic science of tendon pathology and healing into therapeutic and surgical techniques to improve patient care
  • Improve diagnostic tools (imaging, questionnaires, biomarkers) for tendon assessment in human subjects