Abstract
Tendon injury is common and debilitating, and it is associated with long-term pain and ineffective healing. It is estimated to afflict 25% of the adult population and is often a career-ending disease in athletes and racehorses. Tendon injury is associated with high morbidity, pain, and long-term suffering for the patient. Due to the low cellularity and vascularity of tendon tissue, once damage has occurred, the repair process is slow and inefficient, resulting in mechanically, structurally, and functionally inferior tissue. Current treatment options focus on pain management, often being palliative and temporary and ending in reduced function. Most treatments available do not address the underlying cause of the disease and, as such, are often ineffective with variable results. The need for an advanced therapeutic that addresses the underlying pathology is evident. Tissue engineering and regenerative medicine is an emerging field that is aimed at stimulating the body's own repair system to produce de novo tissue through the use of factors such as cells, proteins, and genes that are delivered by a biomaterial scaffold. Successful tissue engineering strategies for tendon regeneration should be built on a foundation of understanding of the molecular and cellular composition of healthy compared with damaged tendon, and the inherent differences seen in the tissue after disease. This article presents a comprehensive clinical, biological, and biomaterials insight into tendon tissue engineering and regeneration toward more advanced therapeutics.
Highlights
Within the field of orthopedic surgery, damage to tendons is the most common soft tissue injury.[1]
The results of this study demonstrated the ability of TGF-b3 to significantly increase the biomechanical and structural properties of the tendon, leading to a better quality tissue when compared with controls.[67,68]
Adenovirus vectors have been used for the delivery of exogenous FAK gene and bone morphogenetic proteins (BMP)-12 gene into chicken tendon cells, resulting in a significant increase in expression of these genes when compared with controls, and in an enhanced healing of tendon tissue.[80,81]
Summary
Within the field of orthopedic surgery, damage to tendons is the most common soft tissue injury.[1]. Adenovirus vectors have been used for the delivery of exogenous FAK gene and BMP-12 gene into chicken tendon cells, resulting in a significant increase in expression of these genes when compared with controls, and in an enhanced healing of tendon tissue.[80,81] Abbah et al conducted studies by using plasmid DNAs encoding decorin and interleukin[10] to co-transfect human tenocytes using polyplexes to Collagen type I
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