Tendon Repair Protocols are structured, evidence-based clinical guidelines that detail the sequential therapeutic interventions required to restore the structural integrity and functional capacity of a damaged tendon. These protocols move through distinct phases, from initial inflammation management to controlled mechanical loading and final return to activity. The objective is to facilitate the synthesis of strong, correctly aligned collagen fibers, thereby preventing chronic tendinopathy and re-injury, a process that is often slow due to poor vascularity.
Origin
This field is a core discipline within orthopedic surgery and physical therapy, with the earliest protocols focusing on immobilization and gradual mobilization. Modern protocols are informed by advances in cellular biology, recognizing the importance of growth factors and mechanical signaling in the repair process. The structured nature of the “Protocol” reflects the necessary precision for optimal biological outcomes in a slow-healing tissue.
Mechanism
The repair process is fundamentally driven by tenocytes, which are stimulated by mechanical load and growth factors to synthesize new collagen matrix. Early phases focus on reducing detrimental inflammation and protecting the tissue from excessive strain. Subsequent phases introduce progressive, controlled mechanical tension, which acts as a powerful signal to align the new collagen fibers along the lines of stress, maximizing tensile strength. Hormonal status, particularly the availability of anabolic hormones, also critically influences the rate and quality of this collagen synthesis.
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