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The Journal of Bone and Joint Surgery 81:259-278 (1999)
© 1999 The Journal of Bone and Joint Surgery, Inc.

Current Concepts Review

Current Concepts Review - Tendinosis of the Elbow (Tennis Elbow). Clinical Features and Findings of Histological, Immunohistochemical, and Electron Microscopy Studies*

BARRY S. KRAUSHAAR, M.D.{dagger}, EMERSON, NEW JERSEY and ROBERT P. NIRSCHL, M.D., M.S.{ddagger}, ARLINGTON, VIRGINIA

Investigation performed at Nirschl Orthopedic Sportsmedicine Clinic, Arlington; Arlington Hospital, Arlington; and Georgetown University Medical Center, Washington, D.C.


   Introduction
 
Tendon injuries can be divided into several categories on the basis of the nature of their onset and the tissues involved. Acute tendon injuries, such as laceration of the flexor tendons of the fingers, are traumatic in nature. Chronic overuse injuries are the result of multiple microtraumatic events that cause disruption of the internal structure of the tendon and degeneration of the cells and matrix, which fail to mature into normal tendon; at times, such injuries result in tendinosis35. The healing of acute tendon injuries has been studied from the perspective of the body's response to lacerations of flexor tendons as well as after operative intervention35,67.

Tendinosis is incompletely understood. Although the term tendinitis is used frequently and often indiscriminately, histopathological studies have shown that specimens of tendon obtained from areas of chronic overuse do not contain large numbers of macrophages, lymphocytes, or neutrophils26,35,59. Rather, tendinosis appears . . . [Full Text of this Article]


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