Natural, synthetic and commercially-available biopolymers used to regenerate tendons and ligaments

Behzad Shiroud Heidari; Rui Ruan; Ebrahim Vahabli; Peilin Chen; Elena M De-Juan-Pardo; Minghao Zheng; Barry Doyle

doi:10.1016/j.bioactmat.2022.04.003

Natural, synthetic and commercially-available biopolymers used to regenerate tendons and ligaments

Bioact Mater. 2022 Apr 13:19:179-197. doi: 10.1016/j.bioactmat.2022.04.003. eCollection 2023 Jan.

Authors

Behzad Shiroud Heidari^{1

2

3}, Rui Ruan^{3

4

5}, Ebrahim Vahabli^{1

2}, Peilin Chen^{3

4

5}, Elena M De-Juan-Pardo^{2

6

7}, Minghao Zheng^{3

4

5}, Barry Doyle^{1

2

3

8}

Affiliations

¹ Vascular Engineering Laboratory, Harry Perkins Institute of Medical Research, QEII Medical Centre and the UWA Centre for Medical Research, The University of Western Australia, Nedlands, 6009, Australia.
² School of Engineering, The University of Western Australia, Perth, Australia.
³ Australian Research Council Centre for Personalised Therapeutics Technologies, Australia.
⁴ Division of Surgery (Orthopaedics), Medical School, The University of Western Australia, Perth, Australia.
⁵ Perron Institute for Neurological and Translational Science, Nedlands, 6009, Australia.
⁶ T3mPLATE, Harry Perkins Institute of Medical Research, QEII Medical Centre and the UWA Centre for Medical Research, The University of Western Australia, Nedlands, 6009, Australia.
⁷ Science and Engineering Faculty, Queensland University of Technology, Brisbane, Queensland, Australia.
⁸ BHF Centre for Cardiovascular Science, The University of Edinburgh, UK.

Abstract

Tendon and ligament (TL) injuries affect millions of people annually. Biopolymers play a significant role in TL tissue repair, whether the treatment relies on tissue engineering strategies or using artificial tendon grafts. The biopolymer governs the mechanical properties, biocompatibility, degradation, and fabrication method of the TL scaffold. Many natural, synthetic and hybrid biopolymers have been studied in TL regeneration, often combined with therapeutic agents and minerals to engineer novel scaffold systems. However, most of the advanced biopolymers have not advanced to clinical use yet. Here, we aim to review recent biopolymers and discuss their features for TL tissue engineering. After introducing the properties of the native tissue, we discuss different types of natural, synthetic and hybrid biopolymers used in TL tissue engineering. Then, we review biopolymers used in commercial absorbable and non-absorbable TL grafts. Finally, we explain the challenges and future directions for the development of novel biopolymers in TL regenerative treatment.

Keywords: Commercial grafts; Hybrid composites; Natural biopolymers; Synthetic biopolymers; Tendon scaffolds.

Publication types

Review