Advanced engineering strategies for biomaterial scaffolds application in tendon-bone interface regeneration

Area of Science:

• Regenerative Medicine
• Biomaterials Science
• Orthopedic Surgery

Background:

• Tendon-bone interface injuries (e.g., rotator cuff tears, ACL ruptures) are difficult to treat due to complex enthesis structure and poor healing.
• Current repair methods often fail to restore the fibrocartilaginous transition, leading to poor integration and retears.
• Biomaterial scaffolds offer biomechanical support and bioactive cues for enhanced regeneration.

Purpose of the Study:

• To review recent advances in biomaterial scaffold engineering for tendon-bone healing.
• To discuss emerging strategies and the structure-signal-function paradigm for multi-tissue integration.
• To identify translational barriers and future directions for clinical application.

Main Methods:

• Review of natural polymers, synthetic polymers, bioceramics, and composite scaffolds.
• Analysis of scaffold designs: monophasic, multiphasic, gradient-based, and functionalized.
• Examination of emerging strategies: immunomodulation, bio-signal delivery, and physical responsiveness.

Main Results:

• Scaffold designs have evolved significantly, incorporating advanced materials and complex architectures.
• The structure-signal-function paradigm is emerging to guide multi-tissue integration.
• Key translational barriers include animal models, manufacturing, safety, regulation, and cost.

Conclusions:

• Advanced scaffold engineering holds transformative potential for functional tendon-bone regeneration.
• Intelligent biomaterials, AI-driven design, and integrated translational frameworks are future directions.
• Successful clinical translation requires interdisciplinary collaboration.