Biomimetic strategies for tendon/ligament-to-bone interface regeneration

Tendon/ligament-to-bone healing poses a formidable clinical challenge due to the complex structure, composition, cell population and mechanics of the interface. With rapid advances in tissue engineering, a variety of strategies including advanced biomaterials, bioactive growth factors and multiple stem cell lineages have been developed to facilitate the healing of this tissue interface. Given the important role of structure-function relationship, the review begins with a brief description of enthesis structure and composition. Next, the biomimetic biomaterials including decellularized extracellular matrix scaffolds and synthetic-/natural-origin scaffolds are critically examined. Then, the key roles of the combination, concentration and location of various growth factors in biomimetic application are emphasized. After that, the various stem cell sources and culture systems are described. At last, we discuss unmet needs and existing challenges in the ideal strategies for tendon/ligament-tobone regeneration and highlight emerging strategies in the field.

Automated summary

This review discusses the challenges and strategies for tendon/ligament-to-bone healing, including biomimetic materials, growth factors, and stem cells. The importance of structure-function relationship, growth factor concentration, and stem cell application in the healing process is highlighted. Unmet needs and emerging strategies in tendon/ligament-to-bone regeneration are also discussed.