title: The mature athlete: aging tendon and ligament.
abstract: BACKGROUND
  Aging changes the biology, healing capacity, and biomechanical function of tendons and ligaments and results in common clinical pathologies that present to orthopedic surgeons, primary care physicians, physical therapists, and athletic trainers. A better understanding of the age-related changes in these connective tissues will allow better patient care.
  
  
  METHODS
  The PubMed database was searched in December 2012 for English-language articles pertaining to age-related changes in tendons and ligaments.
  
  
  METHODS
  Level 5.
  
  
  RESULTS
  The mature athlete faces challenges associated with age-dependent changes in the rotator cuff, Achilles tendon, lateral humeral epicondylar tendons, quadriceps tendon, and patellar tendon. The anterior cruciate ligament and the medial collateral ligament are the most studied intra-articular and extra-articular ligaments, and both are associated with age-dependent changes.
  
  
  CONCLUSIONS
  Tendons and ligaments are highly arranged connective tissue structures that maintain joint motion and joint stability. These structures are subject to vascular and compositional changes with increasing age that alter their mechanotransduction, biology, healing capacity, and biomechanical function. Emerging research into the etiology of age-dependent changes will provide further information to help combat the age-related clinical complications associated with the injuries that occur to tendons and ligaments.
authors.affiliation: Hospital for Special Surgery, New York, New York.
authors.forename: Moira M
authors.initials: MM
authors.lastname: McCarthy
authors.affiliation: Hospital for Special Surgery, New York, New York.
authors.forename: Jo A
authors.initials: JA
authors.lastname: Hannafin
keywords: ACL; Achilles tendon; age-related; biomechanics; ligament; rotator cuff; tendon