The vasculature and its role in the damaged and healing tendon

Tendon pathology has many manifestations, from spontaneous rupture to chronic tendinitis or tendinosis; the etiology and pathology of each are very different, and poorly understood. Tendon is a comparatively poorly vascularised tissue that relies heavily upon synovial fluid diffusion to provide nutrition. During tendon injury, as with damage to any tissue, there is a requirement for cell infiltration from the blood system to provide the necessary reparative factors for tissue healing. We describe in this review the response of the vasculature to tendon damage in a number of forms, and how and when the revascularisation or neovascularisation process occurs. We also include a section on the revascularisation of tendon during its use as a tendon graft in both ligament reconstruction and tendon–tendon grafting.

肌腱病变（tendon pathology）具有多种临床表现，从自发性肌腱断裂（spontaneous rupture）到慢性肌腱炎（tendinitis）或肌腱变性（tendinosis）；各类病变的病因与病理机制差异显著，且目前尚未得到充分认知。肌腱属于相对乏血管组织，主要依靠滑液扩散获取营养。与其他组织损伤类似，肌腱损伤时需要血液系统的细胞浸润，以提供组织修复所需的各类修复因子。本综述将详述不同类型肌腱损伤时脉管系统的应答反应，以及血管重建（revascularisation）或新生血管形成（neovascularisation）过程的发生方式与时机。此外，本综述还将涵盖肌腱作为移植物，用于韧带重建（ligament reconstruction）及肌腱-肌腱移植（tendon–tendon grafting）过程中的血管重建相关内容。