ElbowIn chronic lateral epicondylitis, apoptosis and autophagic cell death occur in the extensor carpi radialis brevis tendon
Section snippets
Materials and methods
Institutional ethics committee approval was granted by Sir Charles Gairdner Hospital Human Ethic committee for this study that analyzed extensor carpi radialis brevis (ECRB) tendon samples obtained during surgical débridement and lateral epicondylar release, as treatment for refractory and severe lateral epicondylitis.
General histology
On H&E staining, the degenerated ECRB samples revealed a highly variable collagen structure and cellular morphology. In grade I areas, collagen fibers were continuously packed in a parallel pattern with slight splitting between bundles, and nearly all tendon cells were spindle shaped and aligned along the fiber orientation (Figure 1, B). In grade II areas, splitting and fragmentation of fiber bundles were common, with intense small blood vessel genesis and cellular proliferation. A large
Discussion
In this study, we demonstrated elevated apoptotic and autophagic cell death rates in chronic lateral epicondylitis samples. The mean apoptotic rate of degenerated ERCB tendon débrided at surgery was 28.7% ± 5.6%, which is much higher than the apoptotic rate of 13% found in normal rotator cuff tendon30 and the 3% to 10% rate found in normal adult articular cartilage.1 Our results are similar to those reported in previous studies that also used the TUNEL assay to detect apoptosis. Yuan et al30
Disclaimer
All authors, their immediate family, and any research foundation with which they are affiliated did not receive any financial payments or other benefits from any commercial entity related to the subject of this article. No external funding was received in assisting this study.
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