Bioscaffolds in Tissue Engineering: A Rationale for Use in the Reconstruction of Musculoskeletal Soft Tissues

One of the main goals in tissue engineering (TE) is the creation and development of tissue that can serve as a substitute for a pathologic or damaged tissue. TE is a new scientific discipline that uses technologies obtained from cell biology, materials science, physical chemistry, and mechanical engineering. The convergence of all these disciplines into a single field has led to a set of unifying principles that entail the unique combination of three key components: a scaffold to provide mechanical support; bioactive molecules (eg, growth factors, extracellular matrix [ECM] molecules, and others) to provide a biologic stimulus; and cells to produce constitutive or biologically active molecules. For musculoskeletal applications, the synthesis and subsequent spatial organization of ECM molecules are imperative for functional tissue formation or histogenesis. It is important to note that the influence of the local environment (eg, paracrine signaling from the surrounding host tissue, mechanical loading after a surgical reconstruction of a ligament) on histogenesis cannot be underestimated and is likely to play an important role in clinical success. The unique combination of these three variables and their presence at the exact temporal and stoichiometric ratios at the healing site should ultimately lead to the desired cellular phenotype and tissue organization. Because the list of possible scaffolds, bioactive molecules, and cells is extremely extensive, each TE strategy is dependent on the target tissue, prevalent clinical practice, patent landscape, and manufacturing Clin Podiatr Med Surg