Less common pains.

<p>Less common pains.</p

Core painful sensations expressed by the participants.

<p>Core painful sensations expressed by the participants.</p

Seven dimensions identified through qualitative analysis.

<p>Seven dimensions identified through qualitative analysis.</p

Interview topic guide.

<p>Interview topic guide.</p

Study selection flow chart.

<p>Study selection flow chart.</p

Improvement by cell therapy of the load-to-failure after repair of Achilles tendons.

<p>We determined the Load-to-failure of Achilles tendons taken from control (G1), chondrocyte- (G2) and MSC-injected (G3) rats 15, 30 and 45 days after repair and compared them to those of a native enthesis (74.4±10.9 N, white box). There was a statistically significant difference between the value for the native entheses and those for other populations at 15 days post-repair. There was a statistically significant difference between the values for the native enthesis and those of G1 and G3 30 days post-repair, and a statistically significant difference between G1 and G2 and G3, 45 days post-repair. * p<0.05, ** p<0.01 and *** p<0.001.</p

Enthesis repair after destruction and mechanical loading.

<p>(A and B) The tendon was retained by a sutures passing through the tendon and two tunnels in the calcaneus bone after destruction of the enthesis. The tunnels were made using a 23G sterile needle (A) and a 4/0 non absorbable suture was passed through the hole to attach the tendon to the bone (B). The plantar side of the calcaneum was placed on a metal rod. The box was fixed to a triangular piece of metal and the fiber part of the muscle was removed, leaving only its aponevrosis fixed in a double-sided tape (C). The proximal tip of the calcaneum was placed on the machine, two CCD cameras were placed at 90° around the sample (frontal and lateral to the calcaneum) to check the positioning (D and E)). A load-to-failure curve was obtained for each sample tested (F).</p

Enthesis structure and healing ratse after repair.

<p>The enthesis is the area of bone-tendon junction. A) Wistar rat Achilles tendon-bone junction. B) Higher magnification of the delimited area shown in (A). T, tendon; Bo, bone. C and D) Type II collagen immunostaining of a native (C) and a destroyed enthesis (D). Native enthesis shows two positive areas of collagen II staining: E1, the insertion of the tendon (T) into the bone (Bo) and E2, the sliding zone of the tendon. Note the absence of the tendon and the E1 area just after destruction of the enthesis (D). (C and D, scale  = 200μm). E and F) Healing failure after repair was evaluated by suture breakage (E) and a distance between the bone and the tendon of greater than 1 cm (F) (E and F, scale  = 1 cm). G) Healing rate was evaluated at sacrifice for the three groups of rats and expressed as a percentage. * p<0.05 and ** p 0.01.</p

MSC and chondrocyte immuno-characterization.

<p>Fluorescent immunostaining. A: type II collagen around chondrocytes and its negative control: B. C: Type I collagen of rat MSCs. D: Fibronectin in rat MSCs. E: Integrin β1 in rat MSCs. F: CD54 in rat MSCs. G: CD45 negative immunostaining of rat MSCs. H: CD14 negative immunostaining of rat MSCs. Scale is 100 µm.</p

Histological scale used to assess the tissue engineering of the enthesis.

<p>The first 3 columns are visual grades assigned by examining x 25 images of the bone-tendon junction. The last 2 columns are assessments of x 100 images. The first column uses sections stained with H&E and the second immunostained for type II collagen. The third column sections were stained with Alcian Blue. Columns 1 to 3 were used to define the production of an enthesis. Columns 2 to 5 were used to rank the organization of the neo-enthesis (16-point scale). The native enthesis always scored 16 points in double blind trials (SD = 0).</p