J. H.-C. Wang, J. Zhang and X. Nirmala Pages 71 - 81 ( 11 )
Millions of people suffer from tendon injuries in both occupational and athletic settings. However, the restoration of normal structure and function to injured tendons remains one of the greatest challenges in orthopaedics and sports medicine. In recent years, several advancements have been made in tendon research that suggest the potential for more effective treatment and repair of tendon injuries. First is the discovery of tendon stem/progenitor cells (TSCs). Recent studies have suggested that TSCs may be responsible for the development of degenerative tendinopathy, a chronic tendon injury. Besides, because TSCs are tendon-specific stem cells, they can potentially be used in cell therapy to effectively repair or even regenerate injured tendons. Second, autologous platelet-rich plasma (PRP) has recently been adopted in orthopaedics and sports medicine to treat acute and chronic tendon injuries. Patients treated with PRP injections have reported a significant reduction in injury-induced pain and improvement in joint function. Finally, engineered tendon scaffolds have been shown to promote tenogenesis of TSCs in animal studies in vitro and formation of tendon-like structures in vivo; hence, they may be effectively used to enhance the repair of injured tendons. In this article, a review is provided on the mechanobiology of TSCs, the efficacy of PRP treatment for tendon injuries and the applications of tendon scaffolds to treat tendon-related disorders in clinical settings. Based on the existing data, it is recommended that a multidimensional approach combining all three tissue engineering elements - TSCs, PRP and scaffolds - be used to enhance the healing of injured tendons.
Cell therapy, mechanical loading, PRP, tendinopathy, tendon injuries, tendon scaffolds, tendon stem cells, tissue engineering.
Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, 210 Lothrop Street, BST, E1640, Pittsburgh, PA 15213, USA.