Tendon
Tendon
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Tendon

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Tendon

A tendon or sinew is a tough band of dense fibrous connective tissue that connects muscle to bone. It sends the mechanical forces of muscle contraction to the skeletal system, while withstanding tension.

Tendons, like ligaments, are made of collagen. The difference is that ligaments connect bone to bone, while tendons connect muscle to bone. There are about 4,000 tendons in the adult human body.

A tendon is made of dense regular connective tissue, whose main cellular components are special fibroblasts called tendon cells (tenocytes). Tendon cells synthesize the tendon's extracellular matrix, which abounds with densely-packed collagen fibers. The collagen fibers run parallel to each other and are grouped into fascicles. Each fascicle is bound by an endotendineum, which is a delicate loose connective tissue containing thin collagen fibrils and elastic fibers. A set of fascicles is bound by an epitenon, which is a sheath of dense irregular connective tissue. The whole tendon is enclosed by a fascia. The space between the fascia and the tendon tissue is filled with the paratenon, a fatty loose connective tissue. Normal healthy tendons are anchored to bone by Sharpey's fibres.

The dry mass of normal tendons, which is 30–45% of their total mass, is made of:

Although most of a tendon's collagen is type I collagen, many minor collagens are present that play vital roles in tendon development and function. These include type II collagen in the cartilaginous zones, type III collagen in the reticulin fibres of the vascular walls, type IX collagen, type IV collagen in the basement membranes of the capillaries, type V collagen in the vascular walls, and type X collagen in the mineralized fibrocartilage near the interface with the bone.

Collagen fibres coalesce into macroaggregates. After secretion from the cell, cleaved by procollagen N- and C-proteases, the tropocollagen molecules spontaneously assemble into insoluble fibrils. A collagen molecule is about 300 nm long and 1–2 nm wide, and the diameter of the fibrils that are formed can range from 50–500 nm. In tendons, the fibrils then assemble further to form fascicles, which are about 10 mm in length with a diameter of 50–300 μm, and finally into a tendon fibre with a diameter of 100–500 μm.

The collagen in tendons are held together with proteoglycan (a compound consisting of a protein bonded to glycosaminoglycan groups, present especially in connective tissue) components including decorin and, in compressed regions of tendon, aggrecan, which are capable of binding to the collagen fibrils at specific locations. The proteoglycans are interwoven with the collagen fibrils – their glycosaminoglycan (GAG) side chains have multiple interactions with the surface of the fibrils – showing that the proteoglycans are important structurally in the interconnection of the fibrils. The major GAG components of the tendon are dermatan sulfate and chondroitin sulfate, which associate with collagen and are involved in the fibril assembly process during tendon development. Dermatan sulfate is thought to be responsible for forming associations between fibrils, while chondroitin sulfate is thought to be more involved with occupying volume between the fibrils to keep them separated and help withstand deformation. The dermatan sulfate side chains of decorin aggregate in solution, and this behavior can assist with the assembly of the collagen fibrils. When decorin molecules are bound to a collagen fibril, their dermatan sulfate chains may extend and associate with other dermatan sulfate chains on decorin that is bound to separate fibrils, therefore creating interfibrillar bridges and eventually causing parallel alignment of the fibrils.

The tenocytes produce the collagen molecules, which aggregate end-to-end and side-to-side to produce collagen fibrils. Fibril bundles are organized to form fibres with the elongated tenocytes closely packed between them. There is a three-dimensional network of cell processes associated with collagen in the tendon. The cells communicate with each other through gap junctions, and this signalling gives them the ability to detect and respond to mechanical loading. These communications happen by two proteins essentially: connexin 43, present where the cells processes meet and in cell bodies connexin 32, present only where the processes meet.

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