Tendon tissue engineering: Cells, growth factors, scaffolds and production techniques

• Published in: Journal of controlled release 2021-05, Vol.333, p.448-486
• Main Authors: Ruiz-Alonso, Sandra, Lafuente-Merchan, Markel, Ciriza, Jesús, Saenz-del-Burgo, Laura, Pedraz, Jose Luis
• Format: Article
• Language: English
• Subjects: 3D printing; growth factor; scaffold development techniques; scaffolds; Tendon regeneration; tissue engineering
• ISSN: 0168-3659; 1873-4995
• DOI: 10.1016/j.jconrel.2021.03.040

Tendon injuries are a global health problem that affects millions of people annually. The properties of tendons make their natural rehabilitation a very complex and long-lasting process. Thanks to the development of the fields of biomaterials, bioengineering and cell biology, a new discipline has emerged, tissue engineering. Within this discipline, diverse approaches have been proposed. The obtained results turn out to be promising, as increasingly more complex and natural tendon-like structures are obtained. In this review, the nature of the tendon and the conventional treatments that have been applied so far are underlined. Then, a comparison between the different tendon tissue engineering approaches that have been proposed to date is made, focusing on each of the elements necessary to obtain the structures that allow adequate regeneration of the tendon: growth factors, cells, scaffolds and techniques for scaffold development. The analysis of all these aspects allows understanding, in a global way, the effect that each element used in the regeneration of the tendon has and, thus, clarify the possible future approaches by making new combinations of materials, designs, cells and bioactive molecules to achieve a personalized regeneration of a functional tendon. [Display omitted] •Tendons are complex tissues with very special mechanical and biological properties•Tissue engineering is a promising strategy for the recovery of injured tendons•Tendon tissue engineering is based on materials, growth factors and cells•New tendon scaffold production strategies allow more effective approaches•The combination of increasingly complex strategies improves tendon regeneration