basic science

Tendon Biology and Healing

intermediate

6 min

28 marks

6 questions

Clinical Scenario

A 42-year-old male recreational basketball player presents 2 days after an acute Achilles tendon rupture while playing. He felt a sudden "pop" with immediate inability to push off. He was treated initially with a plaster backslab. Physical examination confirms the diagnosis with a palpable gap 4cm proximal to insertion and positive Thompson test. He is keen to return to sport and asks about treatment options.

MRI of the ankle is provided.

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Clinical image for Tendon Biology and Healing

Source: Achilles Tendon Rupture MRI • PMC5099495 • CC-BY

Questions

Question 1 (4 marks)

Describe the structure and composition of tendon. What gives tendon its mechanical properties?

Question 2 (5 marks)

Describe the blood supply to tendon. How does this relate to zones of injury?

Question 3 (6 marks)

What are the stages of tendon healing? How do intrinsic and extrinsic healing differ?

Question 4 (5 marks)

What factors affect tendon healing? How does loading influence the healing process?

Question 5 (4 marks)

Compare operative versus non-operative treatment for Achilles tendon rupture. What is the current evidence?

Question 6 (4 marks)

Describe rehabilitation principles for tendon repair.