Novel Implications of Tissue Engineering in the Treatment and Management of Rotator Cuff Tendinopathy

Tendinopathy encompasses one of the most common and debilitating group of injuries in persons of all age. Current treatments range from rest and ice to more invasive mechanisms such as surgical repair or artificial tendon recreation. In recent years, there has been a push to study minimally invasive treatments to aid in the regeneration and repair of damaged tendons. These treatments are yet to show reproducible clinically significant improvement over placebo treatments. Years of research has been put into synthesizing different materials to create scaffolds including metals, bioactive glasses, natural and synthetic polymers. These scaffolds are constructed through one of a variety or complex processes from 3D printing to solvent leaching. These different mechanisms of creation and materials used allow the scaffolds to embody different properties including pore size, thermal stability, strength and pliability. This allows for the utilization of tissue engineering in a multitude of in vivo environments. Many different cell types are used to seed scaffolds including tenocytes, multipotent stem cells and induced pluripotent stem cells. Scaffolds show promise as a delivery system for drugs as well as cytokines and growth factors. Tissue engineering is a novel field of study that shows promise not only for tendon repair but the field of orthopedics as a whole. This paper focuses on systematic review of the principles of tissue engineering and the implications in tendinopathy.