Scaffolds in Tendon Tissue Engineering

Abstract

Tissue engineering techniques using novel scaffold materials offer potential alternatives for managing tendon disorders. Tissue engineering strategies to improve tendon repair healing include the use of scaffolds, growth factors, cell seeding, or a combination of these approaches. Scaffolds have been the most common strategy investigated to date. Available scaffolds for tendon repair include both biological scaffolds, obtained from mammalian tissues, and synthetic scaffolds, manufactured from chemical compounds. Preliminary studies support the idea that scaffolds can provide an alternative for tendon augmentation with an enormous therapeutic potential. However, available data are lacking to allow definitive conclusion on the use of scaffolds for tendon augmentation. We review the current basic science and clinical understanding in the field of scaffolds and tissue engineering for tendon repair.

Freeze-Thaw Cycles Enhance Decellularization of Large Tendons

“…Tendon or ligament ruptures, however, often require surgical replacement and thus a graft based on autologous, allo-or xenogeneic biological, or synthetic materials. 6,[10][11][12] Tendons and ligaments are highly specialized tissues, characterized by high extracellular matrix density, relatively low cellularity and vascularity, and outstanding mechanical properties combining stiffness and elasticity, which makes the design of appropriate bioartificial scaffolds demanding. 10 The ideal scaffold should not only be biocompatible and match the natural biomechanical properties, but should also comprise naturally structured, extracellular matrix proteins that can interact with the repopulating cells and direct them toward tenogenic differentiation and matrix remodeling.…”

“…10 The ideal scaffold should not only be biocompatible and match the natural biomechanical properties, but should also comprise naturally structured, extracellular matrix proteins that can interact with the repopulating cells and direct them toward tenogenic differentiation and matrix remodeling. 10,11 Decellularization of tendon tissue offers the unique opportunity of obtaining a scaffold with a natural extracellular matrix structure that is hypoimmunogenic 13,14 and displays biomechanical properties very similar to the original tissue, [15][16][17][18] providing great advantages for potential clinical application and research use.…”

“…19 Sodium dodecyl sulfate (SDS) was reported to be effective but to reduce cytocompatibility due to matrix alterations; however, the protocol used in these studies did not only include incubation in SDS, but also in Triton X-100. 11,17,22,23 Further, several groups performed detergent-based decellularization with samples that had previously been frozen or freezedried 15,16,24 ; it should be acknowledged that this may have had an additional effect on decellularization effectiveness.…”

Substrate topography: A valuable in vitro tool, but a clinical red herring for in vivo tenogenesis

“…Given that tissue graft based therapies have failed to restore native tendon function, it is anticipated that the tissue-engineering arpeggio (scaffolds, cells, biologics alone or in combination) would provide a functional therapy in the years to come [1][2][3][4][5][6][7][8][9][10][11][12][13].…”

Production and in vitro evaluation of macroporous alginate hydrogel fibres for nerve tissue engineering

“…Hydrogels have been applied as cell support scaffolds for tissue engineering of cartilage [203,[223][224][225][226], cornea [227], skin [228,229], tendon [230], vascular [231] and neural tissue [232][233][234][235] (Table 4.1). Cells are usually suspended in an aqueous precursor solution prior to encapsulation (Figure 4.1) [236].…”