# Grafts in tendon repair

## TL;DR

This paper reviews the use of grafts in tendon repair, focusing on current methods and new developments in tissue engineering to improve healing outcomes.

## Contribution

The paper provides a comprehensive review of tendon grafts and highlights opportunities for improving tendon recovery through engineered constructs.

## Key findings

- Autografts and allografts are the gold standard but have limitations in availability and patient suitability.
- Commercial tendon grafts may not always lead to optimal healing, prompting research into better engineered solutions.
- In vivo animal models are essential for evaluating graft efficacy and translating findings to clinical use.

## Abstract

Inferior healing after tendon rupture often necessitates the use of grafts to reinforce tendon repair and promote the regeneration of functional tissue. Autograft or allograft implantations are considered the gold standard in tendon reconstruction, though these types of treatment may not always be feasible due to limited availability and patient-specific considerations. In such cases, commercial tendon grafts, encompassing bridging and augmenting grafts are preferred but may not always lead to optimal healing. Consequently, research into the development of more effective constructs for tendon repair is constantly evolving. Here, we review progress in the field by considering the structure and biology of tendons as well as the natural tendon healing processes that inform the evolution of tissue engineered tendon grafts. The limitations of commercial tendon constructs are outlined to establish the opportunities presented by a range of structures, materials, and bioactive adjuncts currently being engineered into tendon grafts to improve tendon recovery and regeneration. We present in vivo animal models that have been established to evaluate graft efficacy, and that are critical for the translation to clinical use.

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