Topical Glyceryl Trinitrate for Managing Refractory Tendinopathy
In February 2019 the BMJ published a review of topical nitroglycerin or glyceryl trinitrate (TGN) for the treatment of tendinopathies which I think is worth reviewing . Tendinopathies account for up to 30% of an orthopedic or sports medicine practice. Patients typically present with pain and swelling at the affected tendon with a clear history of overuse from repetitive microtrauma, although acute injuries do occur. Tendinitis refers to acute injuries where inflammation of the tendon results in micro-tears that happen when the musculotendinous unit is acutely overloaded with a tensile force that is too heavy and/or too sudden .
Because of the high incidence of tendinopathies, lets briefly review the current understanding of its pathophysiology. Tendons are designed to withstand considerable loads. At the histological level, changes include reduced numbers and rounding of fibroblasts, increased content of proteoglycans, glycosaminoglycans and water, hypervascularization and disorganized collagen fibrils. At the molecular level, upregulation of RNA for type I and III collagens, proteoglycans, angiogenic factors, stress and regenerative proteins and proteolytic enzymes occurs.
Read More: https://wikism.org/Tendinopathies_(Main)
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