Table Of ContentTendinopathy
From Basic Science to Clinical
Management
Kentaro Onishi
Michael Fredericson
Jason L. Dragoo
Editors
123
Tendinopathy
Kentaro Onishi
Michael Fredericson • Jason L. Dragoo
Editors
Tendinopathy
From Basic Science to Clinical
Management
Editors
Kentaro Onishi Michael Fredericson
Department of Physical Medicine and Department of Orthopedic Surgery
Rehabilitation Division of PM&R
Department of Orthopedic Stanford University
Surgery, University of Pittsburgh Redwood City, CA
Pittsburgh, PA USA
USA
Jason L. Dragoo
Department of Orthopedic Surgery
University of Colorado Denver
Denver, CO
USA
ISBN 978-3-030-65334-7 ISBN 978-3-030-65335-4 (eBook)
https://doi.org/10.1007/978-3-030-65335-4
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Preface
The only source of knowledge is experience.
– Albert Einstein
Tendinopathy is a pervasive and debilitating condition that affects all
walks of life, from a young athlete to an older adult. Because these injuries
affect one's ability to execute basic daily movements and the propensity for
incomplete healing and recurrence are common, this condition's societal bur-
den is enormous. Successful treatment requires in-depth knowledge about
tendon biology, pathophysiology, region-specific anatomy/biomechanics, as
well as current evidence surrounding various treatment options. Ultimately,
the care for a person affected by tendinopathy should be personalized based
on severity, location, and individual goals.
Over the last 30+ years of our combined practice, treatment of tendinopa-
thy has been challenging and very rewarding. Healing painful tendinopathy
after months to years of unsuccessful therapy is immensely satisfying when
we see the patient can run and play the sport he/she enjoys better, their pain
resolves, and their overall function improves. We wrote this book to reference
the basic understanding of tendon biology, tendon pathophysiology, clinical
evaluation and diagnosis, and management based on currently available evi-
dence. Chapters are divided by anatomical areas for ease of use in clinical
practice. The book also features chapters that discuss evolving basic science
and select topics of interest in evolving treatment options for tendinopathy.
The contributors range from basic scientists to both surgical and non-
surgical clinical experts. They were selected based on their expertise. The
peer-reviewed literature along with the author’s experience has become the
knowledge provided in this book. We hope that it gives the reader a better
understanding of this difficult condition.
Pittsburgh, PA, USA Kentaro Onishi
Redwood City, CA, USA Michael Fredericson
Denver, CO, USA Jason L. Dragoo
v
Contents
1 Biological and Biomechanical Adaptation of Young
and Aging Tendons to Exercise . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
James H-C. Wang and Bhavani P. Thampatty
2 The Pathogenic Mechanisms of Tendinopathy . . . . . . . . . . . . . . . 13
James H-C. Wang and Bhavani P. Thampatty
3 Rotator Cuff Tendons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Jonathan S. Kirschner, Lawrence V. Gulotta, and
Terrence Thomas
4 Biceps Tendon . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Alyssa Neph, Michael O’Connell, Jason J. Shin,
Albert Lin, and Eric R. Helm
5 Common Extensor Tendon/Common Flexor Tendon . . . . . . . . . 55
Allison Schroeder, Kentaro Onishi, and Scott Joshua Szabo
6 Wrist and Hand Tendons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
David Impastato, Brian C. Liem, Jerry Huang, and Mark A.
Harrast
7 Rectus Abdominis and Hip Adductor Tendons
(“Athletic Pubalgia/Sports Hernia”) . . . . . . . . . . . . . . . . . . . . . . . 93
Gerardo Miranda-Comas, Eliana Cardozo, Svetlana Abrams,
and Joseph E. Herrera
8 Proximal Hamstring Tendons . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103
Lindsay Ramey Argo, Ryan S. Selley, Vehniah K. Tjong, and
Joseph Ihm
9 Lateral Gluteal Tendons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129
Gerard A. Malanga and Usker Naqvi
10 Quadriceps Tendon . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141
Mark J. Sakr, Joseph M. Powers, Bryson P. Lesniak, David R.
Espinoza, and Gregory V. Gasbarro
11 Patellar Tendon . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165
Ronald Takemoto, Kevin Pelletier, Alex Miner,
Abdullah Kandil, and Abdurrahman Kandil
vii
viii Contents
12 Distal Hamstring, Pes Anserine, and Popliteal Tendons . . . . . . . 177
Christopher Urbanek, Christopher McCrum,
Bryson P. Lesniak, and Jeanne M. Doperak
13 Peroneal Tendons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 195
Mary E. Caldwell, Marc Gruner, Miguel Pelton, Daniel Dean,
Francis Xavier McGuigan, and Arthur Jason De Luigi
14 Anterior/Dorsal Ankle Tendons . . . . . . . . . . . . . . . . . . . . . . . . . . . 213
Kenneth Mautner, Katherine Nanos, and Ashley McCann
15 Medial Ankle/Plantar Foot Tendons . . . . . . . . . . . . . . . . . . . . . . . 225
Rohit Navlani and Stephanie A. Giammittorio
16 Achilles Tendon . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 251
Stephen Schaaf, Ma Calus V. Hogan, and Adam S. Tenforde
17 Plantar Fascia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 265
Vince Si and Melody Hrubes
18 Office-Based Mechanical Procedures for Tendons . . . . . . . . . . . 281
Jesse Charnoff and Joshua B. Rothenberg
19 Office-Based Orthobiologic Procedures for Tendons . . . . . . . . . 323
David J. Cormier, Todd R. Hayano, Lauren Elson, and
Joanne Borg-Stein
20 Office-Based Chemical Procedures for Tendons . . . . . . . . . . . . . 347
Caroline Schepker, Xiaoning Yuan, Zachary Bailowitz, and
Christopher Visco
21 Emerging Operative Procedures for Tendons . . . . . . . . . . . . . . . 355
Nicola Maffulli, Alessio Giai Via, and Francesco Oliva
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 365
Contributors
Svetlana Abrams, DO Department of Rehabilitation and Human
Performance, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Zachary Bailowitz, MD Department of Orthopedics, Podiatry, & Sports
Medicine, Kaiser Permanente Medical Center, Oakland, CA, USA
Joanne Borg-Stein, MD Department of Physical Medicine and
Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital,
Charlestown, MA, USA
Mary E. Caldwell, DO Department of Physical Medicine and Rehabilitation,
Virginia Commonwealth University, Richmond, VA, USA
Eliana Cardozo, DO Department of Rehabilitation and Human Performance,
Icahn School of Medicine at Mount Sinai, New York, NY, USA
Jesse Charnoff, MD Department of Physiatry, Hospital for Special Surgery,
New York, NY, USA
David J. Cormier, DO, DPT Department of Physical Medicine and
Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital,
Charlestown, MA, USA
Daniel Dean, MD Department of Orthopedic Surgery, MedStar Health,
Washington, DC, USA
Arthur Jason De Luigi, DO Department of Physical Medicine and
Rehabilitation, Mayo Clinic, Scottsdale, AZ, USA
Jeanne M. Doperak, DO Department of Orthopedic Surgery, University of
Pittsburgh, Pittsburgh, PA, USA
Lauren Elson, MD Department of Physical Medicine and Rehabilitation,
Harvard Medical School, Spaulding Rehabilitation Hospital, Charlestown,
MA, USA
David R. Espinoza, MD The San Antonio Orthopedic Group (TSAOG),
San Antonio, TX, USA
Gregory V. Gasbarro, MD Department of Orthopedic Surgery, Mercy
Medical Center, Baltimore, MD, USA
ix
x Contributors
Stephanie A. Giammittorio, DO Riverside Medical Group Orthopedics
and Sports Medicine, Williamsburg, VA, USA
Marc Gruner, DO Department of Rehabilitation Medicine, Georgetown
University, Washington, DC, USA
Lawrence V. Gulotta, MD Shoulder and Elbow Division, Sports Medicine
Institute, Hospital for Special Surgery, New York, NY, USA
Mark A. Harrast, MD Department of Rehabilitation Medicine, University
of Washington, Seattle, WA, USA
Todd R. Hayano, DO Department of Physical Medicine and Rehabilitation,
Harvard Medical School, Spaulding Rehabilitation Hospital, Charlestown,
MA, USA
Eric R. Helm, MD Department of Physical Medicine and Rehabilitation,
University of Pittsburgh, Pittsburgh, PA, USA
Joseph E. Herrera, DO Department of Rehabilitation and Human
Performance, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Ma Calus V. Hogan, MD Department of Orthopedic Surgery, University of
Pittsburgh, Pittsburgh, PA, USA
Melody Hrubes, MD Rothman Orthopedics, New York, NY, USA
Jerry Huang, MD Department of Orthpaedics and Sports Medicine,
University of Washington, Seattle, WA, USA
Joseph Ihm, MD Shirley Ryan Ability Lab, Northwestern University,
Chicago, IL, USA
David Impastato, MD UW Medicine Sports Medicine Center at Husky
Stadium, University of Washington, Seattle, WA, USA
Abdullah Kandil, MD Department of Physical Medicine and Rehabilitation,
University of California Irvine, Orange, CA, USA
Abdurrahman Kandil, MD Department of Orthopedic Surgery, Stanford
University, Redwood City, CA, USA
Jonathan S. Kirschner, MD Department of Physiatry, Hospital for Special
Surgery, New York, NY, USA
Bryson P. Lesniak, MD Department of Orthopedic Surgery, University of
Pittsburgh, Pittsburgh, PA, USA
Brian C. Liem, MD UW Medicine Sports Medicine Center at Husky
Stadium, University of Washington, Seattle, WA, USA
Albert Lin, MD Department of Orthopedic Surgery, University of Pittsburgh,
Pittsburgh, PA, USA
Nicola Maffulli, MD, PhD Department of Musculoskeletal Disorders,
School of Medicine and Surgery, University of Salerno, Salerno, Italy
Mary University of London, Barts and the London School of Medicine and
Dentistry, Centre for Sports and Exercise Medicine, Mile End Hospital,
London, UK
Contributors xi
Gerard A. Malanga, MD New Jersey Regenerative Institute, Cedar Knolls,
NJ, USA
Kenneth Mautner, MD Department of Orthopedic Surgery, Emory
University, Atlanta, GA, USA
Ashley McCann, MD Department of Family Medicine, Morehouse School
of Medicine, Atlanta, GA, USA
Christopher McCrum, MD Department of Orthopedic Surgery, University
of Texas Southwestern, Dallas, TX, USA
Francis Xavier McGuigan, MD Department of Orthopedic Surgery,
MedStar Health, Washington, DC, USA
Alex Miner, DO Department of Physical Medicine and Rehabilitation,
University of California Irvine, Orange, CA, USA
Gerardo Miranda-Comas, MD Department of Rehabilitation and Human
Performance, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Katherine Nanos, MD Strive Physiotherapy and Sports Medicine, Toronto,
ON, Canada
Usker Naqvi, MD Las Vegas, Nevada, USA
Rohit Navlani, DO Department of Anesthesiology and Perioperative
Medicine, University of Pittsburgh, Pittsburgh, PA, USA
Alyssa Neph, MD Department of Physical Medicine and Rehabilitation,
University of Pittsburgh, Pittsburgh, PA, USA
Michael O’Connell, DO Department of Physical Medicine and
Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
Francesco Oliva, MD, PhD Department of Musculoskeletal Disorders,
School of Medicine and Surgery, University of Salerno, Salerno, Italy
Kentaro Onishi, DO Department of Physical Medicine and Rehabilitation,
Department of Orthopedic Surgery, University of Pittsburgh, Pittsburgh, PA,
USA
Department of Orthopedic Surgery, University of Pittsburgh, Pittsburgh, PA,
USA
Kevin Pelletier, MD Department of Physical Medicine and Rehabilitation,
University of California Irvine, Orange, CA, USA
Miguel Pelton, MD Tidewater Orthopedics, Suffolk, VA, USA
Joseph M. Powers, MD Northside Hospital Orthopedic Institute, Atlanta,
GA, USA
Lindsay Ramey Argo, MD Department of Physical Medicine and
Rehabilitation, University of Texas Southwestern, Dallas, TX, USA
Joshua B. Rothenberg, DO Orthopedic Group, Baptist Health North
Medical Group, Boca Raton Regional Hospital, Boca Raton, FL, USA
