Biomaterials in Tendon and Skeletal Muscle Tissue Engineering: Current Trends and Challenges

Abstract

Tissue engineering is a promising approach to repair tendon and muscle when natural healing fails. Biohybrid constructs obtained after cells’ seeding and culture in dedicated scaffolds have indeed been considered as relevant tools for mimicking native tissue, leading to a better integration in vivo. They can also be employed to perform advanced in vitro studies to model the cell differentiation or regeneration processes. In this review, we report and analyze the different solutions proposed in literature, for the reconstruction of tendon, muscle, and the myotendinous junction. They classically rely on the three pillars of tissue engineering, i.e., cells, biomaterials and environment (both chemical and physical stimuli). We have chosen to present biomimetic or bioinspired strategies based on understanding of the native tissue structure/functions/properties of the tissue of interest. For each tissue, we sorted the relevant publications according to an increasing degree of complexity in the materials’ shape or manufacture. We present their biological and mechanical performances, observed in vitro and in vivo when available. Although there is no consensus for a gold standard technique to reconstruct these musculo-skeletal tissues, the reader can find different ways to progress in the field and to understand the recent history in the choice of materials, from collagen to polymer-based matrices.

Adipose-derived mesenchymal stem/stromal cells: from the lab bench to the basic concepts for clinical translation

“…Several of the ongoing approaches in regenerative medicine, consider strikingly diverse parameters that influence the biological outcome within the niche of the target tissue. This adds complexity to the equation by introducing various professions (biologists, physicians and materials engineers), to combine their expertises in a single area (tissue engineering), for the creation of more effective treatments (Beldjilali-Labro et al, 2018).…”

Biodegradable polymer nanocomposites for ligament/tendon tissue engineering

“…Most of the research for tendon tissue regeneration proposes the use of Col alone or mixed with other molecules, such as proteoglycans, to produce scaffolds in form of sponges, aligned extruded Col fibers or electrochemically-aligned Col [37]. Regarding ligament regeneration and specifically tissue-engineered ACLs, Col and the L enantiomer of PLA, Poly (L-lactic) acid (PLLA), have been the most used materials to produce biodegradable scaffolds, although some of them do not achieve more than 20% of the ultimate tensile strength of native ACL [8].…”

“…Polyesters such as PCL and PGA, PLLA, poly(Llactide-co-ε-caprolactone) (PLCL) and PLGA have been effectively used to produce mechanically strong and biodegradable scaffolds for tendon/ligament applications- Table 3 [14,35]. These polymers are well characterized and have been approved by the FDA for certain human uses [37]. However, one of the disadvantages of synthetic polymers is the lack of biological cues for promoting cell adhesion and proliferation, which has to be overcome by, for example, applying a specific coating [37].…”

“…These polymers are well characterized and have been approved by the FDA for certain human uses [37]. However, one of the disadvantages of synthetic polymers is the lack of biological cues for promoting cell adhesion and proliferation, which has to be overcome by, for example, applying a specific coating [37].…”

“…Natural materials have the advantage of being biocompatible, recognizable by cells, favoring the cell adhesion and proliferation. However, their quick degradability and low-mechanical properties may limit their application in tissue engineering, while synthetic polymers present low bioactivity and higher mechanical properties [37]. Thus, the combination both types of materials is expected to yield a synergetic effect between natural and synthetic polymers [37], and has been proposed as a good compromise between biological and mechanical performance for tendon and ligament regeneration [83,104].…”