Abstract
Achilles tendon injuries are common and complex especially in athletes and active people. Healing process occurs via scar tissue formation leading to poor outcomes for patients. Current surgical and non-surgical treatment modalities lead to sub-optimal tendon healing and each of them have complications. Therefore, to repair and restore tendon structure and function, a tendon graft is needed; therefore autografts, allografts and xenografts have been used. However, each of these grafts is associated with several limitations such as donor site morbidity and pain, poor biocompatibility, disease transmission and immune reaction which lead to graft rejection and failure. Tissue engineering is an advancing field that can either augment surgical repair or provide an alternative method for Achilles tendon repair. Among the components of tissue engineering technologies, the present article has discussed scaffolds and emphasized on collagen-based biomaterials. This article illustrated the causes behind the essential need for tissue engineering in Achilles tendon repair. Furthermore, it described the current literature regarding the use of collagen in Achilles tendon repair and the main points regarding application of collagen biomaterials and scaffolds in tendon tissue engineering.
Highlights
The incidence of Achilles tendon rupture is increasing and about 75% of all ruptures occur during sport activities among racket sports [1,2]
Surgical treatment is recommended in highly active sport persons because of earlier and safer return to sports [1,2]
These modalities are associated with limitations including tendon adhesion, infection and the risk of tendon re-rupture; there is a need for another promising method to facilitate the healing process of the Achilles tendon defects [1,2]
Summary
The incidence of Achilles tendon rupture is increasing and about 75% of all ruptures occur during sport activities among racket sports [1,2]. This kind of treatment may lead to shorter rehabilitation period and safer return to sport player [4] Various immobilization methods such as casting, functional bracing with or without weight-bearing and range of motion training have been designed in managing tendon injuries [4,5]. These modalities are associated with limitations including tendon adhesion, infection and the risk of tendon re-rupture; there is a need for another promising method to facilitate the healing process of the Achilles tendon defects [1,2]. The purpose of this study was to review the treatment techniques of Achilles tendon injuries to explain how tissue engineering can help in this field. We clarified the advantages and disadvantages of the collagen-based structures, and explained some collagen characteristics and properties with some recent studies
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