Publication: The plantaris tendon in association
with mid-portion Achilles tendinosis –
Tendinosis-like morphological features and
presence of a non-neuronal cholinergic system
Authors
Spang, Christoph ; Alfredson, Hàkan ; Ferguson, Mark ; Roos, Beverley ; Bagge, Johan
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Publisher
F. Hernández y Juan F. Madrid. Universidad de Murcia. Departamento de Biología Celular e Histología
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DOI
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info:eu-repo/semantics/article
Description
Abstract
The plantaris tendon is often neglected in
morphological/clinical studies on the lower extremity.
There is, however, clinical evidence that the plantaris
tendon is involved in cases with Achilles midportion
tendinopathy/tendinosis. It is nevertheless unclear if the
plantaris tendon exhibits tendinosis-like features in this
situation. We therefore investigated the plantaris tendon
of patients with midportion Achilles tendinosis when the
plantaris tendon was found to be located very close to or
invaginated into the Achilles tendon, a situation which
very often has been found to be the case. There was a
very large number of tenocytes in the tendon tissue and
the tenocytes showed abnormal and irregular
appearances, exhibiting widened/rounded and wavy
appearances, and were frequently lined up in rows.
These features are characteristic features in Achilles
tendinosis tendons. The tendon cells showed a distinct
immunoreaction for the acetylcholine (ACh) -producing
enzyme choline acetyltransferase (ChAT). Frequent
fibroblasts were found in the loose connective tissue and
these cells also showed a marked ChAT immunoreaction.
The study shows that the plantaris tendon is
morphologically affected in a similar way to the Achilles
tendon in cases with midportion Achilles tendinosis and
medial pain. The plantaris tendon may accordingly be a
co-factor in these cases. The results also favour that
there is a local ACh production both within the tendon
tissue of the plantaris tendon and in the loose connective
tissue. In conclusion, it is evident that plantaris tendons
lying invaginated into or very close to the Achilles
tendon in cases with midportion Achilles tendinosis show similar tendinosis features as previously shown for
the Achilles tendon itself in these cases.
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Citation
Histology and histopathology, Vol. 28, n.º 5 (2013)
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