Tendon tissue engineering: The potential application of stem cells, biological factors, and repair scaffolds to improve rotator cuff tendon tears

© 2011 Elsevier B.V. All rights reserved. High failure rates associated with traditional surgical repair of rotator cuff tears have encouraged the search for new methods to improve surgical repair. Assuming that optimal surgical techniques are being employed, then it is possible that surgical repairs may require augmentation either mechanically or biologically. Tissue-engineering approaches are being used increasingly to identify applications which could augment surgical repairs. Various approaches to the problem of tendon healing have been employed. Additional mechanical support is offered by augmentation patches, which are both biological and synthetic. Enhancement of healing is encouraged by the use of stem cells and biological agents. This article reviews all three areas of research, particularly focusing on their application to rotator cuff tendon tears. Though promising, no single treatment currently offers effective and definitive healing outcomes. It may therefore be prudent to modify approaches by combining two or three of these factors. Stem cells could be applied to tendons with concomitant use of biological factors to enhance healing, and delivered by an appropriate scaffold or delivery vehicle.