Abstract
The tendon is a highly aligned connective tissue that transmits force from muscle to bone. Each year, more than 32 million tendon injuries have been reported, in fact, tendinopathies represent at least 50% of all sports injuries, and their incidence rates have increased in recent decades due to the aging population. Current clinical grafts used in tendon treatment are subject to several restrictions and there is a significant demand for alternative engineered tissue. For this reason, innovative strategies need to be explored. Tendon replacement and regeneration are complex since scaffolds need to guarantee an adequate hierarchical structured morphology and mechanical properties to stand the load. Moreover, to guide cell proliferation and growth, scaffolds should provide a fibrous network that mimics the collagen arrangement of the extracellular matrix in the tendons. This review focuses on tendon repair and regeneration. Particular attention has been devoted to the innovative approaches in tissue engineering. Advanced manufacturing techniques, such as electrospinning, soft lithography, and three-dimensional (3D) printing, have been described. Furthermore, biological augmentation has been considered, as an emerging strategy with great therapeutic potential.
Highlights
Tendinopathies could be accompanied by inflammation and pain, whereas tendinosis and ruptures are caused by intertendinous degeneration without the evidence of inflammatory processes [1]
This is due to the peculiarity of the tendon-to-bone interface (TBI), a hybrid complex tissue that serves as shock-absorber of transmission forces between the tendon and the bone
This review will focus on tendon structures and their junctions to bones or muscles, the injuries, common treatments to restore limb functions, and the recent strategies of tissue engineering based on three-dimensional (3D) scaffolds and biological augmentation
Summary
Tendon disorders are medical conditions, such as ruptures and overuse injuries, and inflammatory and degenerative disorders, such as tendinopathies. Non-healing tendon injuries frequently require surgical treatment, and despite recent advancements in orthopedic surgery, many common tendon repair techniques yield less than optimal results [3,4,5]. At the tendon–bone interface, many common tools used in surgery, such as suture anchors, cannot regenerate the enthesitis, resulting in a high incidence of re-rupture [6,7]. This is due to the peculiarity of the tendon-to-bone interface (TBI), a hybrid complex tissue that serves as shock-absorber of transmission forces between the tendon and the bone. This review will focus on tendon structures and their junctions to bones or muscles, the injuries, common treatments to restore limb functions, and the recent strategies of tissue engineering based on three-dimensional (3D) scaffolds and biological augmentation
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