A New Tissue Engineering Strategy to Promote Tendon–bone Healing: Regulation of Osteogenic and Chondrogenic Differentiation of Tendon‐derived Stem Cells

In the field of sports medicine, repair surgery for anterior cruciate ligament (ACL) and rotator cuff (RC) injuries are remarkably common. Despite the availability of relatively effective treatment modalities, outcomes often fall short of expectations. This comprehensive review aims to thoroughly examine current strategies employed to promote tendon‐bone healing and analyze pertinent preclinical and clinical research. Amidst ongoing investigations, tendon‐derived stem cells (TDSCs), which have comparatively limited prior exploration, have garnered increasing attention in the context of tendon‐bone healing, emerging as a promising cell type for regenerative therapies. This review article delves into the potential of combining TDSCs with tissue engineering methods, with ACL reconstruction as the main focus. It comprehensively reviews relevant research on ACL and RC healing to address the issues of graft healing and bone tunnel integration. To optimize tendon‐bone healing outcomes, our emphasis lies in not only reconstructing the original microstructure of the tendon‐bone interface but also achieving proper bone tunnel integration, encompassing both cartilage and bone formation. In this endeavor, we thoroughly analyze the transcriptional and molecular regulatory variables governing TDSCs differentiation, incorporating a retrospective analysis utilizing single‐cell sequencing, with the aim of unearthing relevant signaling pathways and processes. By presenting a novel strategy rooted in TDSCs‐driven osteogenic and chondrogenic differentiation for tendon‐bone healing, this study paves the way for potential future research avenues and promising therapeutic applications. It is anticipated that the findings herein will contribute to advancing the field of tendon‐bone healing and foster the exploration of TDSCs as a viable option for regenerative therapies in the future.