Trend of Bioactive Molecules and Biomaterial Coating in Promoting Tendon—Bone Healing

Abstract

The tendon-bone junction (TBJ) is a graded structure consisting of tendons, nonmineralised, and mineralised fibrocartilage and bone. Given the complex gradient of the TBJ structure, TBJ healing is particularly challenging. Injuries to the TBJ such as anterior cruciate ligament (ACL) tears and rotator cuff injuries are common and serious sports injuries, affecting more than 250,000 patients annually in the United States, particularly people older than 50 years. ACL reconstruction and rotator cuff repair are the commonly performed TBJ repair surgeries. However, the re-tear rate is high post-operation. In recent years, studies on improving TBJ healing have focused on promoting tendon-bone integration at tendon sites. This process includes the use of periosteum, hydrogels, scaffolds, growth factors, stem cells or other reconstruction materials that promote bone growth or ligament attachment. In this study, we will highlight the utilisation of the unique properties of biomaterial coating in promoting tendon-bone healing and discuss recent advances in understanding their role in TBJ healing. Furthermore, we aim to provide a systematic and comprehensive review of approaches to promoting TBJ healing.