Abstract
Tendon injuries are prevalent and problematic, especially among young and otherwise healthy individuals. The inherently slow innate healing process combined with the inevitable scar tissue formation compromise functional recovery, imposing the need for the development of therapeutic strategies. The limited number of low activity/reparative capacity tendon-resident cells has directed substantial research efforts towards the exploration of the therapeutic potential of various stem cells in tendon injuries and pathophysiologies. Severe injuries require the use of a stem cell carrier to enable cell localisation at the defect site. The present study describes advancements that injectable carriers, tissue grafts, anisotropically orientated biomaterials, and cell-sheets have achieved in preclinical models as stem cell carriers for tendon repair.
Highlights
Large tendon injuries that necessitate surgical intervention are of significant concern among athletes, and in the general population
Tendons develop fibrocartilage and ossification in response to injury [120] and Bone marrow-derived mesenchymal stem cell (BMSC) implantation has resulted in ectopic bone formation in mouse [121], rat [122] and rabbit [123,124,125] models, overwhelming preclinical results in small animal models demonstrate improved tendon healing, biomechanics and histological characteristics (Table 1)
Whether these results can be reproduced in large animal models, which are subject to similar forces to humans and will allow acquisition of more clinically relevant data, will have to be seen
Summary
Large tendon injuries that necessitate surgical intervention are of significant concern among athletes, and in the general population. Electro-spun polylactide-co-glycolide scaffolds, loaded with heparin/fibrin hydrogel, ADSCs and platelet derived growth factor BB demonstrated improved tendon healing in a dog model of transected flexor digitorum profundus tendons [119] These studies show that aligned fibrous scaffolds that closely imitate the architecture of tendon tissue offer structural and mechanical benefits, along with an instructive physical environment that guides new functional tissue development. ACL, anterior cruciate ligament; ADSC, adipose-derived stem cell; BMSC, bone marrow-derived mesenchymal stem cell; PDGF BB, platelet derived growth factor BB; PLGA, polylactide-co-glycolide; PRP, platelet rich plasma; TSC, tendon stem cell
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