Soft tissue damage occurs due to direct or indirect trauma to muscles, joint capsules and ligaments. Direct trauma or macro-trauma refers to an injury due to sudden overload on ligaments or joint capsules. Indirect trauma results from repeated sub-maximal loading leading to clinical symptoms and signs. Whether injury is caused due to direct or indirect trauma, the ultimate result is tissue dysfunction characterized by inflammation, pain, and altered internal tissue stress. Of all the tissues involved, the least elastic tissue is a tendon.
Examination of an injury in soft tissues such as muscles is done through initial palpation with minimal compression or force in case of acute injuries. If pain has not been provoked at the site, then higher loads or firmer compression is used. Some of the examination techniques used to examine soft tissue damage are inspection, palpation, and peripheral nerve tests, deep tendon reflexes, strength and motor control tests, and gait analysis.
Tissue repair refers to the replacement of a destroyed tissue by a living tissue. It essentially comprises of two components viz. regeneration and repair. In regeneration, the damaged tissue is replaced through the proliferation of surrounding specialized cells which are undamaged. In repair, the damaged tissue is replaced by a granulation tissue that matures to form a scar tissue. The repair process generally comprises of the bleeding, inflammation, proliferation, and remodeling phases. The bleeding phase is a relatively shorter phase and occurs following a trauma or injury. The inflammatory phase increases in magnitude for up to 1 to 3 days before resolving gradually over the next few weeks. The proliferation phase involves generation of repair material such as the scar material. The remodeling phase is important in context of therapy and rehabilitation. In the final outcome, the damaged tissue is repaired with a scar tissue which enables quality recovery from the injury.
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The key driving factors for the global orthopedic soft tissue repair market are the rising incidence of sports injuries, increasing geriatric population and obesity in aging people. Sports injuries are a major cause for muscle damage. Usually sports and related physical activities result in damage of the anterior cruciate ligament (ACL). According to 2016 national health statistics report by the U.S. Department of Health and Human Services, on an average, American people aged five years and above sustained around 8.6 million sports and recreation related injuries every year between 2011 and 2014. Geriatric population is more vulnerable to damage of the orthopedic soft tissues as aging may result into changes in skeletal system leading to weak ligaments, arthritis, and ACL tear. Obesity in aging people can increase the possibility of degenerative bone disorders such as osteoporosis and osteoarthritis. The high cost of orthopedic soft tissue repair surgeries and availability of non-surgical alternatives such as PRP (Platelet Rich Plasma) injection can decrease the demand for surgical orthopedic soft tissue repair procedures in the coming years.
With high healthcare expenditure in developed countries, advanced orthopedic soft tissue repair procedures are being designed and developed to facilitate enhanced repair and replacement of damaged tissues. With a rising acceptance of sports on a professional level in developing countries, incidence of sports injuries will prevail over the next few years. Also, due to the presence of high unmet medical needs in emerging nations, acceptance of advanced and affordable orthopedic soft tissue repair procedures will witness a rise in coming years. Increased life expectancy due to advancements in healthcare will ensure prevalence of geriatric population across the globe, which will further contribute to the growth of global orthopedic soft tissue repair market.
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Some of the key players in this market are Stryker Corporation, Arthrex, Inc., DePuy Synthes, Inc., Zimmer Biomet, CONMED Corporation, ArthroCare Corporation, and Smith & Nephew plc. These companies focus on strategic acquisitions and mergers in order to gain competitive advantage. For instance, in July 2015, Integra Lifesciences acquired TEI Biosciences Inc. and TEI Medical Inc. to broaden Integra’s portfolio for regenerative wound care and tissue repair. This acquisition offers a regenerative technology platform to the surgeons for indications in wound repair and soft tissue reconstruction.
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