Regeneration techniques for bone-to-tendon and muscle-to-tendon interfaces reconstruction

Introduction: The complex structure of the bone-tendon and muscle-tendon junctions makes their reproduction for tissue engineering applications very difficult. Relatively few studies have investigated the characteristics of these regions from a tissue engineering view point. Sources of data: PubMed, Thomson Reuters, Scopus and Google Scholar databases were searched using various combinations of the keywords 'Tendon', 'Myotendinous junction', 'Osteotendinous junction', 'Tissue engineering' and 'Scaffold'. Areas of agreement: The available studies can be divided according to whether the objective is to build an entire composite tissue unit or to assist the recreation of interfaces, such as improving integration of autografts with the surrounding bone or with the muscle. The most used techniques are based on the electrospinning and the self-reorganized constructs process, which were applied to both bone-to-tendon junction (BTJ) and muscle-to-tendon junction (MTJ) regeneration. The use of nanofibers that mimic the hierarchical structure of the extracellular matrix (ECM), eventually functionalized by encapsulation of bioactive components, allowed cell attachment and differentiation. Areas of controversy: There have been no translational investigations. Growing points: There is a need to devise suitable techniques that allow suitable tissue engineering of BTJ and MTJ. Areas timely for developing research: Appropriately planned studies are needed to translate tissue engineering from a scientific challenge to a clinically applicable technique.