Engineering tendon and ligament tissues: present developments towards successful clinical products

Abstract

Musculoskeletal diseases are one of the leading causes of disability worldwide. Among them, tendon and ligament injuries represent an important aspect to consider in both athletes and active working people. Tendon and ligament damage is an important cause of joint instability, and progresses into early onset of osteoarthritis, pain, disability and eventually the need for joint replacement surgery. The social and economical burden associated with these medical conditions presents a compelling argument for greater understanding and expanding research on this issue. The particular physiology of tendons and ligaments (avascular, hypocellular and overall structural mechanical features) makes it difficult for currently available treatments to reach a complete and long-term functional repair of the damaged tissue, especially when complete tear occurs. Despite the effort, the treatment modalities for tendon and ligament are suboptimal, which have led to the development of alternative therapies, such as the delivery of growth factors, development of engineered scaffolds or the application of stem cells, which have been approached in this review.

Advances in Tendon and Ligament Tissue Engineering: Materials Perspective

“…Tendon injuries present significant healthcare challenges due to slow healing rates, loss of function, and scar tissue formation around trauma sites [12]. In severe cases, tissue engineered scaffolds have been fabricated to replace the lost tissues.…”

“…The ideal scaffold in tendon tissue engineering should exhibit specific properties such as controlled degradation rates, appropriate mechanical properties, nonimmunogenicity, and suturability. Additionally, easy mass processing and fabrication, while mimicking the native tissue environment, are desirable [12].…”

“…To overcome this clinical issue, additional therapeutic options involving the use of synthetic prosthesis or tissue engineered biomaterial constructs have been investigated in the literature [12]. Ranges of synthetic prosthetic devices have been described as tendon and ligament tissue substitutes.…”

Desarrollo De Una Prótesis Regenerativa De Tendón

“…Cuando se compara la calidad de los tendones reparados quirúrgicamente, con la de los tendones sanos, se observa que los primeros están funcionalmente debilitados. Esto implica un mayor riesgo de fallo mecánico y la posible recurrencia de una segunda cirugía [29]. Por estas razones, la Ingeniería Tisular se presenta como una alternativa a emplear para obtener substitutos de tendones que puedan restaurar las características estructurales y las funciones fisiológicas del tejido natural.…”

“…En la presente tesis doctoral se ha diseñado y fabricado un nuevo prototipo de prótesis tendinosa biodegradable, la cual se espera que sea totalmente reabsorbida por el organismo sin provocar ningún efecto negativo permaneciendo el nuevo tejido formado. Esto no sucede cuando se implanta una prótesis permanente, ya que no tienen la capacidad de regenerarse y con el tiempo sufren de alguna manera, un fallo mecánico que da lugar a una segunda cirugía [29].…”