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Histologic Stages of Healing Correlate with Restoration of Tensile Strength in a Model of Experimental Tendon Repair


Much current research is focused on biologic enhancement of the tendon repair process. To evaluate the different methods, which include a variety of gene therapy and tissue engineering techniques, histological and biomechanical testing is often employed. Both modalities offer information on the progress and quality of repair; however, they have been historically considered as two separate entities. Histological evaluation is a less costly undertaking; however, there is no validated scoring scale to compare the results of different studies or even the results within a given study. Biomechanical testing can provide validated outcome measures; however, it is associated with increased cost and is more labor intensive. We hypothesized that a properly developed, objective histological scoring system would provide a validated outcome measure to compare histological results and correlate with biomechanics. In an Achilles tendon model, we have developed a histological scoring scale to assess tendon repair. The system grades collagen orientation, angiogenesis, and cartilage induction. In this study, histology scores were plotted against biomechanical testing results of healing tendons which indicated that a strong linear correlation exists between the histological properties of repaired tendons and their biomechanical characteristics. Concordantly, this study provides a pragmatic and financially feasible means of evaluating repair while accounting for both the histology and biomechanical properties observed in surgically repaired, healing tendon.

This article appears in HSS Journal: Volume 6, Number 2.
View the full article at springerlink.com.

About the HSS Journal

HSS Journal, an academic peer-reviewed journal, is published twice a year, February and September, and features articles by internal faculty and HSS alumni that present current research and clinical work in the field of musculoskeletal medicine performed at HSS, including research articles, surgical procedures, and case reports.


Andrew J. Rosenbaum, BS
Feinstein Institute for Medical Research, North Shore-LIJHS
Robert Wood Johnson Medical School

Jordan F. Wicker, BS
Feinstein Institute for Medical Research, North Shore-LIJHS

Lawrence Bonasser, PhD
Department of Mechanical Engineering, Cornell University

Pasquale Razzano, MS
Feinstein Institute for Medical Research, North Shore-LIJHS
Headshot of Joshua S. Dines, MD
Joshua S. Dines, MD
Associate Attending Sports Medicine Service, Hospital for Special Surgery
Associate Professor of Orthopaedic Surgery, Weill Cornell Medical College
Headshot of David M. Dines, MD
David M. Dines, MD
Attending Orthopedic Surgeon, Hospital for Special Surgery
Professor, Weill Cornell Medical College
Daniel A. Grande, PhD
Feinstein Institute for Medical Research, North Shore-LIJHS

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