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Weakened tendons can also be caused by diseases that disrupt blood supply, including: Chronic kidney failure High cholesterol Inflammatory diseases (rheumatoid arthritis, systemic lupus erythematosus) Diabetes mellitus Infection Metabolic disease Surgery Previous surgery around the tendon, such as a total knee replacement or anterior cruciate ligament reconstruction, might put you at greater risk for a tear

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References 1 Nature Medicine (2014)Nicotinamide N-methyltransferase knockdown protects against diet-induced obesity (preclinical)