Metabolic Influences on Risk for Tendon Disorders

Paul W. Ackermann, David A. Hart

Paul W. Ackermann, David A. Hart

Painful and non-healing musculoskeletal disorders, eg. tendinopathy, pose a tremendous burden on society and the quality of life for patients. New advances in the understanding of connective tissue disorders such as tendinopathy reveal that common health problems such as obesity, atherosclerosis, hormonal dysfunctions and diabetes mellitus are closely linked to the metabolism of components of the musculoskeletal system, particularly tendons. As tendons function as multi-component "organ systems" (Muscle-TMJ-Tendon-Enthesis to Bone), tendons can be influenced directly, or indirectly via, for instance, alterations to muscle. However, this volume/set of chapters focus mainly on the tendon.Emerging findings in musculoskeletal research have established important new links in our understanding of tendon metabolism. Thereby, the function of the neuroendocrine/-immune axis, as well as supply of neuro-vascular factors, can be directly linked to the quality of tendon metabolism.Since some conditions, eg. atherosclerosis and diabetes mellitus, are more common in individuals as they age, and aging can also affect pain and tissue repair, convergence of such complications will potentially exert an increasingly significant impact on tendons as the demographics of many societies change with expanding percentages of the populations >60-65 years of age.Comorbidities related to metabolic dysfunction have to be identified early in patients with musculoskeletal disorders, such as acute tendon injuries or chronic tendinopathy, for therapeutic considerations regarding both operative and non-operative treatment protocols. Necessary interactions between researchers and clinicians with different subspecialties have to be initiated in order to optimize tissue metabolism for improved healing potentials.