Bioreactors for Tendon Tissue Engineering

Tendon tissues have very important load-bearing and load-transferring functions. Also tendon tissues are very prone to injuries that can dramatically affect a patient’s quality of life and are difficult to manage successfully with current available therapies. Regenerative approaches following tendon tissue engineering (TTE) principles have sought to augment the injured tendon with stem cells, scaffolds, and mechanical stimulus to improve natural healing responses. In fact, combinatorial tenogenic cues may involve adequate topographical, biochemical, and mechanical signals for recapitulating native cellular microenvironment and promoting regeneration. Hence, for the successful implementation of TTE therapies, all aspects of tendon function and requirements should be considered in the in vitro maturation of constructs prior to implantation. In this sense, bioreactor systems represent attractive tools to provide biomechanical signaling to cells-laden constructs under closely monitored and tightly controlled environments. This chapter discusses specific roles of biomechanical stimulation in tendons and the most frequently used bioreactor systems in tendon tissue engineering field.