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The role of inflammation in chronic tendinopathy is controversial and highly debated. For these reasons the systematic review by Dean et al 1 is a welcome contribution. It is a dispassionate examination of the role of inflammatory cells in chronic tendinopathy. It highlights that macrophages and mast cells in particular are present in elevated levels in chronic symptomatic tendinopathy in humans. Clearly this does not imply that chronic tendinopathy is primarily an inflammatory condition. Nevertheless this review adds weight to the argument that to think of chronic tendinopathy as purely a degenerative condition is an oversimplification.2 The fact that the Dean et al review is restricted to human tissue adds to the importance of the conclusions.
Four reasons why the role of inflammation in tendinopathy remains a hot topic
Chronic tendinopathy is extremely common. It is often career threatening to the athlete and causes enormous …