Cell Sheet Technology for Tendon and Ligament Tissue Engineering

Tendon and ligament injuries are very common and affect many people worldwide. Tendon and ligament injuries may cause serious morbidity to the patients as these tissues play a very important role in body mobility. Cell sheet technology is one of the new tissue engineering approaches introduced to promote tendon and ligament repair. Cell sheets for tendon and ligament repair are commonly prepared using mesenchymal stem cells and tendon/ligament-derived stem cells. Due to their poor mechanical properties, cell sheets are used to wrap around the ligated tendon/ligament, the graft, and the engineered tendon/ligament to hasten tissue regeneration. To date, the application of cell sheet technology in tendon and ligament repair is still at an early stage. However, results from the preclinical studies are promising. Generally, cell sheets were found to hasten tendon and ligament healing, promote graft integration at the tendon-bone interface, and improve the mechanical strength of the healed tissues. More studies, especially the randomised clinical trials, are needed in the future to validate the efficacy of cell sheets in tendon and ligament repair.