eli5: How do tendons RE-attach to bone post-surgery?

Question

I found other posts about how tendons attach to bone. However, as someone who recently underwent rotator cuff surgery to fix a completely torn tendons, I am curious as to what triggers the tendons to re-attach to the bone (re-bind to the bone if you will)? in my case, I know I have plastic anchors that will eventually desolve or be absorbed by the body. Does the surgeon apply some sort of glue? How does the body trigger the re-attachment process, after the tendons has been seperated from the bone for months?

In: 4

Answer 1

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Answer 2

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Answer 3

They heal like any other injury. Blood in the region goes a little funny, says that something is wrong, more Blood with damage repair bots go to the region, the body senses there is more damage, and will slowly rebuild.

The more in depth version, the tendons attach to bone through a cartilaginous membrane that acts as a glue. The screws that hold your tendon in place keep it close enough to where that membrane will regrow so that it will reattach to the tendon.

The body just knows you grow that membrane to a certain depth. It won’t, generally, regrow forever until it hits a tendon unless you have other problems. Part of the repair surgery will damage the membrane and simulate regrowth. The tendon needs to be kept close enough to that area that the membrane grows around it. This takes a long time because there really aren’t a lot of blood vessels in this type of tissue.

Your body knows there is damage based on different nerve signals (or lack of signal) from specific areas, as well as damage to tissues releasing some agents in your blood that will indicate that area needs special attention.

The cells that repair stuff release more of those agents leading to more cells coming to repair stuff. This is part of why you often see inflammation around areas that are damaged, there’s a lot of blood trying to get there to fix things.

Areas with less blood access heal slower, and we’ve come full circle to why it takes tendons longer to reattach than something like a cut or a fracture.