New strategies for tendon healing

This review describes structure, function and healing of tendinous tissue a nd discusses new biologically based treatment options to modulate tendon he aling. The repair process after tendon rupture results in a morphologically different and biomechanically inferior structure compared to a normal tend on. The collagen fibril diameters are decreased months after the traumatic lesion and show also different phenotypes. We know that cytokines and growt h factors are key components for normal tissue development and regulate wou nd healing processes. Some growth factors have been detected to influence t enocytes by promoting cell proliferation and matrix synthesis. Application of the adequate growth factors at certain periods during the repair process might improve the healing result after tendon rupture. However, most of th ese growth factors are proteins which are rapidly metabolized by the organi sm. Transfer of growth factor genes into tenocytes might eliminate this pro blem by a continuous local release of growth factors at the healing site.