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Is the Tendon Embryogenesis Process Resurrected during Tendon Healing?

Ingraham, John M. M.D.; Hauck, Randy M. M.D.; Ehrlich, H. Paul Ph.D.

Plastic and Reconstructive Surgery: September 1st, 2003 - Volume 112 - Issue 3 - p 844-854
doi: 10.1097/01.PRS.0000070180.62037.FC

The process of embryonic tendon development, including the nature and purpose of collagen fibril segments, is reviewed. It is proposed that tendon fibrillogenesis of repair is related to the fibrillogenesis of tendon embryonic development. The assembly of collagen fibril segment units into longer fibers occurs on the surface of tendon fibroblasts in embryonic tendon development. The biochemist’s view of tendon healing, whereby the spontaneous polymerization of tropocollagen monomers regenerates lost tendon collagen fibers, needs to be reconsidered. Furthermore, the importance of direct fibroblast involvement in collagen fiber reassembly during tendon healing needs to be studied in tendon intrinsic regenerative repair.

Hershey, Pa.

From the Penn State College of Medicine, and Department of Surgery, Milton S. Hershey Medical Center.

Received for publication December 19, 2002.

H. Paul Ehrlich, Ph.D.

Division of Plastic Surgery, H071

500 University Drive

Hershey, Pa. 17033

©2003American Society of Plastic Surgeons