Tendon - function-related structure, simple healing process and mysterious ageing

Tendons are connective tissue structures of paramount importance to human ability of locomotion. The understanding of their physiology and pathology is gaining importance as advances in regenerative medicine are being made today. So far, very few studies were conducted to extend the knowledge about pathology, healing response and management of tendon lesions. In this paper we summarise actual knowledge on structure, process of healing and ageing of the tendons. The structure of tendon is optimised for the best performance of the tissue. Despite the simplicity of the healing response, numerous studies showed that the problems with full recovery are common and much more significant than we thought; that is why we discussed the issue of immobilisation and mechanical stimulation during healing process. The phenomenon of tendons' ageing is poorly understood. Although it seems to be a natural and painless process, it is completely different from degeneration in tendinopathy. Recent studies of biological treatment reported faster and optimal healing of the tendons when augmented by growth factors and stem cells. Despite advances in biology of tendons, management of their injuries is still a challenge for physicians; therefore, further studies are required to improve treatment outcomes.