Abstract

The natural healing capacity of the tendon tissue is limited due to the hypovascular and cellular nature of this tissue. So far, several conventional approaches have been tested for tendon repair to accelerate the healing process, but all these approaches have their own advantages and limitations. Regenerative medicine and tissue engineering are interdisciplinary fields that aspire to develop novel medical devices, innovative bioscaffold, and nanomedicine, by combining different cell sources, biodegradable materials, immune modulators, and nanoparticles for tendon tissue repair. Different studies supported the idea that bioscaffolds can provide an alternative for tendon augmentation with an enormous therapeutic potentiality. However, available data are lacking to allow definitive conclusion on the use of bioscaffolds for tendon regeneration and repairing. In this review, we provide an overview of the current basic understanding and material science in the field of bioscaffolds, nanomedicine, and tissue engineering for tendon repair.

Highlights

  • Tendon is a viscoelastic connective tissue interposed between bones and muscles with the primary function to transmit the force generated during striated muscle contraction to the skeleton, allowing the joint movement

  • We focused our attention on stem cell therapy and different materials used for scaffold construction highlighting the advantages of resulting 3D scaffolds as delivery systems for growth factors, cells, and/or genes compared to conventional therapies

  • Synthetic scaffolds provide promising results, for instance, the lack of signaling molecules and mechanical brittleness restrict their wide range of applications in tissue engineering [67, 68]. Several polyesters such polylactic acid (PLA), polyglycolic acid (PGA), and PLGA have widely been explored for tendon tissue repair

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Summary

Introduction

Tendon is a viscoelastic connective tissue interposed between bones and muscles with the primary function to transmit the force generated during striated muscle contraction to the skeleton, allowing the joint movement. Scaffolds are an effective technological option for chronic and acute tendon repair, allowing at the same time an improved healing rate and high quality/functionality of repaired tissue In these attempts, scaffolds with suitable mechanical biofunctional properties can be surgically implanted at the injured site in order to recapitulate the events for tendon tissue regeneration [10]. Based on the wide range of materials available to date, the selective process plays a pivotal role, and it is influenced by several parameters like biodegradability, compatibility, severity of injury, and type of tendon tissue [16,17,18] Despite these promising characteristics, there are several questions to be investigated yet and the development of a safe bioactive scaffold shows suitable mechanical/biophysical properties, able to provide at the same time an adequate physical support for cell proliferation and differentiation and support the regeneration and cure of injury tissue. We described the applications of nanocarriers in tissue engineering and the potential giant step forward which the combination of these two technologies (nanoparticles and scaffolds) may provide to tendon regeneration

Structure and Function of Tendon
Tendon Injuries and Its Types
Natural Healing of Tendon Tissue
Conventional Treatment Strategies
Materials Used for New Approaches to Tendon Repair
Gene Delivery Systems
Growth Factor Delivery Systems
Stem Cell Therapy
Results
50 Co-culture
10. Mechanical Stimulation
11. Nanoparticles and Tendon Regeneration
12. Conclusion and Future Perspectives
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