18 resultados para Tendinitis posquirúrgicas

em Repositório Institucional UNESP - Universidade Estadual Paulista "Julio de Mesquita Filho"


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Estudou-se o efeito de aplicações intratendíneas do polissulfato de glicosaminoglicanas (PSGAG) no tratamento de tendinite induzida pela colagenase. Dois grupos (GI e GII) de cinco eqüinos da raça Puro-Sangue Árabe, machos e fêmeas, com idades entre dois e seis anos, foram submetidos à tendinite do tendão flexor digital superficial do membro torácico esquerdo por aplicação intratendínea de 1,0ml de colagenase (2,5mg/ml). Decorridos sete dias da indução da lesão, os eqüinos do GI receberam cinco aplicações intralesionais de 1,0ml (125mg) de PSGAG, a intervalos de quatro dias, enquanto que os do GII receberam aplicações de solução fisiológica em igual volume e freqüência. Efetuaram-se avaliações clínicas e ultra-sonográficas, periodicamente, durante 150 dias. Todos os animais apresentaram claudicação e aumento local de sensibilidade, de temperatura e de volume 24 horas após a indução da lesão. Com exceção do aumento de volume, que permaneceu visível até o final do experimento, observou-se regressão de todos os sinais em todos os animais. A avaliação ultra-sonográfica evidenciou lesões de tamanho, forma e posição variados, de maior severidade entre o sétimo e 23º dia. Ao término do experimento, o grau de ecogenicidade encontrava-se entre 1 e 2, e o grau de paralelismo entre 0 e 2. A análise histopatológica evidenciou áreas cicatriciais com intensa fibroplasia e neovascularização, fibras colágenas pouco organizadas e endotendão hipercelular e espessado. Não se observou diferenças significativas entre os grupos quanto ao processo de reparação das lesões, concluindo-se que a aplicação intralesional de PSGAG não produziu efeito benéfico para tratar tendinite induzida por colagenase.

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Superficial digital flexor tendonitis is an important cause of lameness in horses and its incidence ranges from 13% to 30%, depending on the horse's activity. This injury can occur in yearlings and compromise its carriers by reinjury or even impossibility to return to athletic life. In spite of the long period required for tendon repair, the scar tissue presents lack of elasticity and stiffness. As current treatment strategies produce only marginal results, there has been great interest in research of therapies that influence the quality or the speed of tendon repair. Stem cell therapy has shown promising results in degenerative diseases and cases of deficient healing processes. This study aims to evaluate the influence of autologous mesenchymal bone marrow stem cells in tendon healing, comparing treated and non-treated tendons. Superficial digital flexor tendonitis lesions were induced by collagenase infiltration in both forelimbs of 6 horses, followed by autologous implant in one of the forelimbs of each animal. The horses were evaluated using clinical, ultrasonographic, histopathologic, and immunohistochemical parameters. Tendon biopsies were performed at Day 48. Results found in the treatment group, such as high inflammatory cells infiltration, extracellular matrix synthesis, reduced amount of necrosis areas, small increase in cellular proliferation (KI-67/MIB-1), and low immunoreactivity to transforming growth factor P I, suggested the acceleration of tendon repair in this group. Further studies should be conducted in order to verify the influence of this treatment on later phases of tendon repair. Overall, after analysis of the results, we can conclude that cellular therapy with the mononuclear fraction of bone marrow has accelerated tendon repair at 48 days after treatment.

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Tendinitis is an important disease that leads to lameness and decreased performance in equine athletes and results in high costs associated with therapy due to a long recovery period and a high rate of recurrence. Although, several treatments for equine tendinitis have been described, few are effective in significantly improving the quality of the extracellular matrix and reducing the rate of recurrence. The use of cell therapy with mesenchymal stem cells (MSCs) derived from various sources has received much attention because of its therapeutic potential for equine tendinitis. In this paper, we review patents on stem cell therapy and the specific use of MSCs for the treatment of equine tendinitis. © 2013 Bentham Science Publishers.

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Tendinous lesions are very common in athlete horses. The process of tendon healing is slow and the quality of the new tissue is often inferior to the original, leading in many cases to recurrence of the lesion. One of the main reasons for the limited healing capacity of tendons is its poor vascularization. At present, cell therapy is used in equine practice for the treatment of several disorders including tendinitis, desmitis and joint disease. However, there is little information regarding the mechanisms of action of these cells during tissue repair. It is known that Mesenchymal Stem Cells (MSCs) release several growth factors at the site of implantation, some of which promote angiogenesis. Comparison of blood flow using power Doppler ultrasonography was performed after the induction superficial digital flexor tendon tendinitis and implantation of adipose tissue-derived MSCs in order to analyze the effect of cell therapy on tendon neovascularization. For quantification of blood vessel histopathological examinations were conducted. Increased blood flow and number of vessels was observed in treated tendons up to 30 days after cell implantation, suggesting promotion of angiogenesis by the cell therapy.

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Objective. - To describe the distribution of frequency of the injuries during adventure competition.Material and methods. - Fifty-five participants who underwent to the second stage of the Caloi Adventure Camp competition answered to a questionnaire about their personal characteristics, training status and injuries.Results. - The age of the athletes was 32 +/- 10 years old and the body mass index (BMI) 23.3 +/- 2.2 kg/m(2). The most frequent injuries occurred during trekking (61%), followed by mountain bike (24%). Abrasions (36.7%) and cuts (24.5%) were the most frequent injuries mentioned. Tissue level lesions occurred in 61.2% of the episodes. The most frequent injuries were contusions (16.3%) at muscular level, and sprain (6.1%) and fracture (6.1%) at osteoarticular system. Related to the body structure, the lower limb was the most affected (49%), mainly ankle (14.3%) and knee (12.2%). In the upper limb (30.6%), arm and forearm were more affected with cuts and abrasions. Neck and trunk were responsible for 20.4% of the injuries. Cramps (31%) and tendinitis (11%) were also mentioned.Conclusion. - The data suggest that it is necessary to create one training approach including prevention and logistics for participants rescue and rapid attendance during the tournament. (C) 2008 Published by Elsevier Masson SAS.

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In the present study, the effects of intralesional injections of beta-aminopropionitrile fumarate (BAPN-F) was assessed in equine experimental tendinitis. BAPN-F is a lathyrogen which inhibits crosslinking of collagen, permitting more time for parallel reorientation of the repair tissue. Sixteen two-year-old Arabian horses without health problems were used in this experiment. The animals were divided into two groups: group one was left in box rest, and group two was submitted to controlled exercise during the experiment. Tendinitis was induced with collagenase in the superficial flexor tendon of both forelimbs. Twenty days after the induction of tendinitis, intralesional treatment with BAPN-F was performed and the contralateral limbs received saline. A biopsy was obtained and gross and histopathological analysis was performed on the 150th day of the experiment. The collagen fibrillar alignment pattern in the heating area was better in the BAPN-F group submitted to controlled exercise than in the other group, as observed by sonographic and histopathologic examination. The present results indicate that BAPN-F in combination with controlled loading improved sear remodeling and tendon wound collagen maturation.

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Introduction. Tendon injury is a major cause of lameness and decreased performance in athletic equines. Various therapies for tendonitis have been described; however, none of these therapies results in complete tissue regeneration, and the injury recurrence rate is high even after long recovery periods involving rest and physiotherapy. Methods. A lesion was induced with collagenase gel in the superficial digital flexor tendon in the center portion of the metacarpal region of eight equines of mixed breed. After two weeks, the lesions of the animals in the treated and control groups were treated through the intralesional administration of mesenchymal stem cells derived from adipose tissue (adMSCs) suspended in platelet concentrate (PC) and with phosphate buffered saline (PBS), respectively. Serial ultrasound analyses were performed every two weeks. After 16 weeks of therapy, a biopsy was performed for histopathological, immunohistochemical and gene expression (type I collagen (COL1A1), type III collagen (COL3A1), tenascin-C (TNC), tenomodulin (TNMD), and scleraxis (SCX)) analyses. Results: Differences in the ultrasound and histopathological analyses were observed between the groups. Improved results were reported in the group treated with adMSCs suspended in PC. There was no difference in the gene expression levels observed after the different treatments. The main results observed from the histopathological evaluation of the treated group were as follows: a prevention of the progression of the lesion, a greater organization of collagen fibers, and a decreased inflammatory infiltrate. A lack of progression of the lesion area and its percentage was observed in the ultrasound image, and increased blood flow was measured by Power Doppler. Conclusions: The use of adMSCs combined with PC for the therapy of experimentally induced tendonitis prevented the progression of the tendon lesion, as observed in the ultrasound examination, and resulted in a greater organization and decreased inflammation, as observed in the histopathological evaluation. These data demonstrate the therapeutic potential of this therapy for the treatment of equine tendonitis. © 2013 Carvalho et al.; licensee BioMed Central Ltd.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Brazil has the fourth largest horse herd in the world, this is due the recognition and appreciation that the different equestrian games are having within the country. Injuries of the tendon, especially in the digital flexor tendon, are the main cause of athletic life reduction among horses. The treatment of tendinitis in horses seeks full recovery of the damage tissue reestablishing the function previously lost, however conventional treatments have proven to be ineffective when considered the quality of the scar tissue and the rate of recurrence. Due to this, the use of adult stem cells to the treatment of musculoskeletal injuries of horses has been studied for some time. This method of treatment consists of aspiration of bone marrow or removal of subcutaneous fat tissue and implantation of these cells in the injured tissue. After obtaining the bone marrow the implantation can be performed with total bone marrow, with the mononuclear fraction of MSC or with cells cultured in vitro. From the fat tissue is used the stromal vascular fraction obtained by collagenase digestion, followed or not by cell culture. According to some studies, cell therapy with material obtained from bone marrow or adipose tissue has shown to be viable, given that these materials are abundant in repair components such as mesenchymal stem cells (MSC), growth factors and other components of the collagen matrix. Several studies using both types of cells have shown great potential and promising clinical results. However, knowledge of the biology and characterization of these cells remain largely unknown, and therefore is needed great care and caution when using stem cells for the treatment of musculoskeletal disorders in horses