Advances in injured tendon engineering with emphasis on the role of collagen implants

Abstract

IntroductionTendon injuries represent a significant clinical challenge to orthopaedic surgeons and investigators. Recently, many investigators claimed the beneficial effects of tissue engineering technologies in full-thickness tendon and ligament injuries both in vivo and in vitro. In this regard, several fabrication technologies with various types of biomaterials have been specially developed in recent years. In the present review, designing, fabrication and application of tissue-engineered products accentuating the role of collagen bioimplants in tendon tissue engineering is discussed. Conclusion Tissue engineering methods have not been able to differentiate the unimodal small-sized newly generated collagen fibrils from those of multi-modally differentiated fibrillar sizes of various diameters that are present in the normal tendons of a mature animal.

Tendon and Ligament Tissue Engineering, Healing and Regenerative Medicine

“…Tissue engineering is another option which has been introduced in the last decade and currently it is the final option in managing large and massive tendon and ligament injuries [22][23][24][25][26][27][28][29][30][31][32]. Tissue engineering is defined as "a process that affects the structure and architecture of any viable and nonviable tissue with the aim to increase the effectiveness of the construct in biologic environments" [12].…”

“…Basically, tissue engineering could be divided into four major categories including tissue scaffolds, healing promotive factors, stem cells and gene therapy [12]. The fourth category ''Gene Therapy'' has been recently included in tissue engineering [12,24].…”

“…Scaffolds are the most important part of tissue engineering because they have many applications and without them application of promotive factors and stem cells have low clinical value because their long term availability without attachment to the scaffolds is questionable [12,[22][23][24][25][26][27][28][29][30][31][32]. Tissue scaffolds have several duties but their major role is to provide a suitable environment for cell attachment, migration, proliferation and matrix remodeling and regeneration [12].…”

“…All these available options have their own significant limitations [3]. Tissue engineering is a newer option and is divided into four categories of scaffold, healing promotive factors, stem cells and gene therapy [22][23][24][25][26][27][28][29][30][31][32]. Using each or a combination of them have provided the new insights in orthopedic surgery [12,24,[30][31][32].…”

“…Using each or a combination of them have provided the new insights in orthopedic surgery [12,24,[30][31][32]. To design a proper and well approved tissue engineered based graft to be considered as a substitution of traditional grafts, the knowledge about tendon and ligament healing, modeling and remodeling is important [12,24]. In this review we discussed tendon and ligament injuries, have introduced the available and future options in managing large and massive tendon and ligament defects, specifically focused and discussed about the role of tissue engineering in reconstruction of the tendon and ligament defects and finally, described several important events of tendon and ligament healing, modeling and remodeling.…”