Abstract
Tendon and ligament are soft connective tissues that play essential roles in transmitting forces from muscle to bone or bone to bone. Despite significant progress made in the field of ligament and tendon regeneration over the past decades, many strategies struggle to recapitulate basic structure-function criteria of native ligament/tendon. The goal here is to provide a fundamental understanding of the structure and composition of ligament/tendon and highlight few key challenges in functional regeneration of these connective tissues. The remainder of the review will examine several biomaterials strategies including biomimetic scaffold with non-linear mechanical behavior, hydrogel patch with anisotropic adhesion and gene-activated scaffold for interactive healing of tendon/ligament. Finally, emerging technologies and research avenues are suggested that have the potential to enhance treatment outcomes of tendon/ligament injuries.
Highlights
Basic Anatomy of Tendon/LigamentComposition Tendon and ligament are crucial components of the musculoskeletal system that serve important mechanical roles in providing joint stability and enabling mobility
As Dochevaa et al reviewed, there are several growth factors participate in the repair of tendon/ligament, including bone morphogenetic proteins (BMP), connective tissue growth factor (CTGF), insulin-like growth factor-1(IGF-1), basic fibroblast growth factor, platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF) and transforming growth factor beta (TGFβ) (Docheva et al, 2015), which promote the synthesis of collagen, glycosaminoglycan and other extracellular matrix (ECM), improve cell proliferation and angiogenesis, change the way of tendon healing, and enhance their mechanical properties
We focus on emerging strategies for the design and implementation of Tissue Engineered Medical Products (TEMPs) to promote tendon/ligament repair, we highlight few strategies which we believe could greatly boost tendon/ligament repair in the future including: 1) biomimetic fibrous scaffold which mimic the unique biomechanical properties of tendon/ligament, 2) Bioinspired hydrogel patch with anisotropic surface adhesion to reduce postoperative adhesion and 3) biomaterial-assisted gene therapy for in-site drug delivery to facilitate tendon/ligament repair (Law et al, 2016)
Summary
Basic Anatomy of Tendon/LigamentComposition Tendon and ligament are crucial components of the musculoskeletal system that serve important mechanical roles in providing joint stability and enabling mobility. The remainder of the review will examine several biomaterials strategies including biomimetic scaffold with non-linear mechanical behavior, hydrogel patch with anisotropic adhesion and gene-activated scaffold for interactive healing of tendon/ligament.
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