[Tissue engineering of tendons and ligaments. A new challenge]

Injuries to ligaments and tendons heal by formation of inferior repair tissue. This may result in severe joint dysfunction. Because of an increased occurrence of sports-related injuries, musculoskeletal disorders may become one of the major burden of health care. Tissue engineering offers the potential to improve the quality of ligament and tendon tissues during the healing process and may provide a more effective approach to the treatment of injuries to ligaments and tendons than traditional methods. Application of growth factors, gene transfer techniques, cell therapy and cell-matrix composites have shown to affect the process of ligament and tendon healing. The benefits of using mesenchymal stem cells on a three dimensional biological matrix have been shown recently. Tissue engineering will also include mechanical manipulation of tissue environments to accelerate cell differentiation and to improve matrix formation. Fibroblast-seeded polymer scaffolds could be useful in ligament and tendon replacement in which autogenous fibroblasts would be obtained through biopsy, cultured and seeded onto a scaffold.