Research in Orthopedics

Scientific Discoveries to Improve Tendon Health

Leading-edge research is revolutionizing our understanding of how tendons respond to exercise. The group is gaining transformative insight into exercisebased treatments for tendinopathy, offering hope to patients suffering from this painful condition.

Tendinopathy is a prevalent and painful condition affecting millions of patients worldwide, characterized by tendon pain, swelling, and impaired function. It accounts for over 30 % of overuse injuries in Switzerland, disproportionately affecting athletes and older adults, making it a significant concern in sports medicine and general orthopedic medicine. Although a person's pain caused by tendinopathy can often be successfully managed by physiotherapy, much work remains to be done in addressing the fundamental biological causes.

The Laboratory of Orthopedic Biomechanics, under the leadership of Balgrist University Hospital Vice Chair for Research and ETH Zurich Prof. Dr. Jess Snedeker, is at the forefront of tendon science. The group fuses advanced engineering approaches and deep biological investigation to systematically explore tendon behavior under mechanical stress. The laboratory employs cutting-edge multi-scale functional imaging tools that are revealing how our tendons respond at the cellular level, and how this response affects the whole tissue and the patient. Their sophisticated scientific approaches not only provide comprehensive insight into tendon biomechanics but also lays the groundwork for pioneering innovative treatment methods. The laboratory also emphasizes the importance of understanding the patient‘s journey through tendinopathy. 

By collaborating closely with radiologists, surgeons, and physical therapists, Prof. Snedeker's team ensures that their discoveries are grounded in real-world clinical applications. This integration of clinical practice and research creates a unique feedback loop, where laboratory findings directly inform treatment strategies, while challenges Scientific Discoveries to Improve Tendon Health in clinical setting drive further scientific inquiry. For example, by analyzing the differential responses to physical therapy among various patient demographics, the team is developing more nuanced models of tendon pathology. These models consider not just genetic predispositions and biochemical markers but also lifestyle factors such as diet, exercise habits, and even occupational stressors. This holistic approach aims to uncover not only how tendinopathies develop but also how they can be prevented in populations at risk.

A recent study led by Tobias Götschi and Fabian Passini from Prof. Snedeker's team has highlighted the significant impact of patient-specific factors on tendon properties, focusing on gene variants that influence the functionality of mechanosensitive ion channels in tendon cells. These channels are crucial for converting mechanical input into biological responses, playing a pivotal role in how tendons adapt to physical stress. 

These groundbreaking discoveries are transforming our understanding of tendon biology and significantly enhancing our approach to diagnosing and treating tendon disorders in patients. The research findings are crucial for developing personalized medical approaches, where treatment and preventive measures can be precisely customized based on an individual‘s unique biological profile. An important fact is that understanding the influence of genetic and other patient-specific factors on tendon health aids in the precise prediction and strategic management of tendon responses to physical stress. This opens up potential pathways for the development of targeted therapies. These innovative therapies could specifically tailor a person's exercise regimen to adjust their tendon tissue quality and function, thereby optimizing tissue repair and regeneration.

This targeted approach is expected to lead to more effective and personalized rehabilitation strategies for patients suffering from tendinopathy soon. The implications of the group's basic scientific advancements extend beyond the treatment of tendon disorders. They also contribute significantly to our broader understanding of musculoskeletal health, highlighting the intricate relationship between patient-specific factors and physical conditioning.

The work of the Laboratory of Orthopedic Biomechanics represents a source of hope for patients afflicted with tendinopathy that is difficult to treat. With pioneering research that expertly bridges engineering and biology, the laboratory is not only enhancing our understanding of tendon physiology but also leading the development of innovative treatment modalities that promise to revolutionize orthopedic care and significantly improve patients' quality of life.

Gesundheit der Sehnen verbessern dank personalisierter Sehnentherapie

Tendinopathie ist eine weitverbreitete und schmerzhafte Erkrankung, die weltweit Millionen Menschen betrifft, insbesondere sporttreibende und ältere Erwachsene. In der Schweiz werden über 30 % der Überlastungsschäden durch Tendinopathie verursacht. Die gängige physiotherapeutische Behandlung konzentriert sich auf Symptommanagement, ohne die biologischen Ursachen zu bekämpfen. Das Forschungslabor für Orthopädische Biomechanik der Universitätsklinik Balgrist und der ETH Zürich unter der Leitung von Prof. Dr. Jess Snedeker steht an der Spitze der Sehnenforschung. Es verbindet fortschrittliche Ingenieurtechniken mit biologischer Forschung, um das Verhalten von Sehnen unter mechanischer Belastung zu untersuchen. Modernste bildgebende Verfahren auf mehreren Skalen enthüllen, wie Sehnen auf zellulärer Ebene reagieren und diese Reaktionen das gesamte Gewebe beeinflussen. Eine Studie von Tobias Götschi zeigt, wie patientenspezifische Faktoren, wie genetische Varianten, die Funktion von mechanosensitiven Ionenkanälen in Sehnenzellen beeinflussen. Diese Kanäle sind entscheidend für die Umwandlung von mechanischen Eingaben in biologische Reaktionen. Die Erkenntnisse unseres Labors ermöglichen personalisierte medizinische Ansätze, bei denen Behandlungen und präventive Massnahmen individuell angepasst werden können. Dies könnte zu gezielten Therapien führen, die die Qualität und Funktion von Sehnengewebe anpassen, was die Gewebereparatur und -regeneration optimiert und zu effektiveren Rehabilitationsstrategien für Tendinopathie-Patientinnen und -Patienten führt. Die Forschungsergebnisse haben weitreichende Implikationen über die Behandlung von Sehnenerkrankungen hinaus und verbessern unser Verständnis der muskuloskelettalen Gesundheit, indem sie die komplexen Zusammenhänge zwischen patientenspezifi schen Faktoren und körperlicher Kondition aufzeigen. Unser Labor ist ein Vorreiter in der Entwicklung von innovativen Behandlungsmethoden, die die orthopädische Pflege revolutionieren und die Lebensqualität der Betroffenen erheblich verbessern könnten.

At a Glance

Scientific Discovery for Tendon Health: Pioneering Efforts to Understand how our Tendons Respond to Exercise in Sport and Therapy

Key Collaborators
Project lead: Prof. Dr. Jess Snedeker
Dr. Tobias Götschi

Departments and Partners
Balgrist University Hospital, Biomechanics
Institute for Biomechanics, ETH Zurich

Clinical Relevance
Enabling clinicians to achieve better patient outcomes through personalized tendon therapy, optimizing treatment efficacy based on individual diagnostic profiles

Further Information 
> Laboratory for Orthopaedic Biomechanics