13 - Scaffolds for tendon tissue engineering

Abstract

Tendon disorders are among the most frequent musculoskeletal ailments with high clinical rates. Available therapeutic options are often ineffective, and surgical tendon reconstruction is limited by the availability of viable tissue for transplantation. Therefore, there is a growing clinical need for reproducible and effective treatment strategies. Tendon tissue exhibits a hierarchically organized collagenous structure, which effectively transfers muscle-generated forces to the skeleton. Consequently, tendons are subjected to extreme and repetitive mechanical stresses, which can lead to acute or chronic injuries. The low number of active tissue-resident cells results in limited tissue turnover, which makes tendon tissue repair a slow process, often resulting in the formation of a vascularized scar tissue with inferior functional properties to the preinjury tissue. Because tendon is a relatively avascular tissue, engineered tissue replacement is a promising approach aiming to restore native tendon structure and function. This chapter provides an overview and critically discusses biomaterial- and tissue graft-based approaches for tendon tissue engineering.