Tendon and ligament regeneration and repair: clinical relevance and developmental paradigm.
TLDR
A greater understanding of the molecular mechanisms involved in T/L development and natural healing, coupled with the capability of producing complex biomaterials to deliver multiple biofactors with high spatiotemporal resolution and specificity, should lead to regenerative procedures that more closely recapitulate T/l morphogenesis.Abstract:
Tendon and ligament (T/L) are dense connective tissues connecting bone to muscle and bone to bone, respectively. Similar to other musculoskeletal tissues, T/L arise from the somitic mesoderm, but they are derived from a recently discovered somitic compartment, the syndetome. The adjacent sclerotome and myotome provide inductive signals to the interposing syndetome, thereby upregulating the expression of the transcription factor Scleraxis, which in turn leads to further tenogenic and ligamentogenic differentiation. These advances in the understanding of T/L development have been sought to provide a knowledge base for improving the healing of T/L injuries, a common clinical challenge due to the intrinsically poor natural healing response. Specifically, the three most common tendon injuries involve tearing of the rotator cuff of the shoulder, the flexor tendon of the hand, and the Achilles tendon. At present, injuries to these tissues are treated by surgical repair and/or conservative approaches, including biophysical modalities such as physical rehabilitation and cryotherapy. Unfortunately, the healing tissue forms fibrovascular scar and possesses inferior mechanical and biochemical properties as compared to native T/L. Therefore, tissue engineers have sought to improve upon the natural healing response by augmenting the injured tissue with cells, scaffolds, bioactive agents, and mechanical stimulation. These strategies show promise, both in vitro and in vivo, for improving T/L healing. However, several challenges remain in restoring full T/L function following injury, including uncertainties over the optimal combination of these biological agents as well how to best deliver tissue engineered elements to the injury site. A greater understanding of the molecular mechanisms involved in T/L development and natural healing, coupled with the capability of producing complex biomaterials to deliver multiple growth factors with high spatiotemporal resolution and specificity, will allow tissue engineers to more closely recapitulate T/L morphogenesis, thereby offering future patients the prospect of T/L regeneration, as opposed to simple tissue repair.read more
Citations
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Advances in the Development of Anti-Adhesive Biomaterials for Tendon Repair Treatment
Haiying Zhou,Hui Lu +1 more
TL;DR: Anti-adhesion biomaterials should focus on affordable raw materials with wide sources, and the production process should be simplified, in this way, the versatility and targeting of materials will be improved.
Journal ArticleDOI
Bioreactors in tissue engineering: Advances in stem cell culture and three‐dimensional tissue constructs
TL;DR: The present review provides a concise overview about recent developments in bioreactors for stem cell expansion, perfusion bioreactor systems for 3D cultures, and bioreActors for physical stimulation.
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Platelet-rich plasma promotes recruitment of macrophages in the process of tendon healing.
Hirofumi Nishio,Yoshitomo Saita,Yohei Kobayashi,Tomoiku Takaku,Shin Fukusato,Sayuri Uchino,Takanori Wakayama,Hiroshi Ikeda,Kazuo Kaneko +8 more
TL;DR: This study demonstrated that PRP enhanced the tendon healing and promoted the recruitment of MPs to the injured tissue, suggesting that leukocytes in PRP influence the effect of PRP therapy.
Journal ArticleDOI
Understanding the relation between structural and mechanical properties of electrospun fiber mesh through uniaxial tensile testing
Prasoon Kumar,Rajesh Vasita +1 more
TL;DR: In this paper, the mechanical behavior of electrospun fiber meshes at different length scales was investigated and a correlation between their structure and mechanical properties was established for tissue engineering, filtration, and textiles, owing to their high surface area per unit mass.
Journal ArticleDOI
Regenerative Engineering of the Rotator Cuff of the Shoulder.
TL;DR: Various strategies to regenerate rotator cuff tendons using stem cells, advanced materials, and factors in the setting of physical forces under the Regenerative Engineering paradigm are described.
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