Similar histopathological picture in males with Achilles and patellar tendinopathy

Nicola Maffulli, Vittorino Testa, Giovanni Capasso, Stanley W. Ewen, Alessio Sullo, Francesco Benazzo, John B. King

Research output: Contribution to journalArticlepeer-review


Purpose: To ascertain whether there are differences in the histopathological appearance of tendinopathic Achilles and patellar tendons. Methods: In males, we studied biopsies from tendinopathic Achilles (N = 28; average age 34.1 yr) and patellar tendons (N = 28; average age 32.1), Achilles tendons (N = 21; average age 61.8 yr) from deceased patients with no known tendon pathology, and patellar tendons (N = 15; average age 28.3) from patients undergoing anterior cruciate ligament reconstruction. Hematoxylin-eosin stained slides were interpreted using a semiquantitative grading scale (0: normal to 3: maximally abnormal) for fiber structure, fiber arrangement, rounding of the nuclei, regional variations in cellularity, increased vascularity, decreased collagen stainability, and hyalinization. All slides were assessed blindly twice, the agreement between two readings ranging from 0.170 to 0.750 (kappa statistics). Results: The highest mean score of tendinopathic Achilles tendons was not significantly different from that of tendinopathic patellar tendons (11.6 ± 5 and 10.4 ± 3, respectively). The ability to differentiate between an Achilles tendon and a patellar tendon was low. Conclusions: Tendinopathic Achilles and patellar tendons show a similar histological picture. It was not possible to identify whether a specimen had been harvested from an Achilles or a patellar tendon on the basis of histological examination. The general pattern of degeneration was common to both tendinopathic Achilles and patellar tendons. A common, as yet unidentified, etiopathological mechanism may have acted on both these tendon populations.

Original languageEnglish
Pages (from-to)1470-1475
Number of pages6
JournalMedicine and Science in Sports and Exercise
Issue number9
Publication statusPublished - Sep 2004


  • Etiology
  • Histopathology
  • Surgery
  • Tendinosis

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Physical Therapy, Sports Therapy and Rehabilitation
  • Orthopedics and Sports Medicine


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