Background and objective: Tendon injuries are common musculoskeletal conditions that affect both athletic and working populations. Although surgical intervention remains the mainstay of treatment for large tendon injuries, conventional approaches often result in suboptimal healing and functional outcomes. Recent evidence has shown that stem cell therapy may play a role in the management of these injuries. This review comprehensively examines the current literature on stem cell applications in tendon regeneration by analyzing both preclinical and clinical evidence. Specifically, we evaluated various stem cell populations, their characteristics, delivery mechanisms, and repair processes. Additionally, we addressed the limitations of stem cell-based therapies while highlighting emerging trends and future research directions in this rapidly evolving field.
Methods: PubMed was searched for articles published in August 2025. Boolean operators "Tendon" OR "Tendon repair" OR "Tendon regeneration" OR "Tendon injury" AND "Scaffold" AND "Secretomes" OR "Exosomes" OR "Stem Cells" were used to search for articles. Inclusion criteria included studies within the last 10 years, performed on humans or animals, written in English, as well as articles considered clinical trials, meta-analyses, randomized controlled trials, reviews, or systematic reviews. We identified approximately 1,800 studies, which were screened for relevance to our topic. Additional reference screenings and targeted searches were performed to identify other relevant studies.
Key content and findings: With advancements in regenerative medicine and material science, new solutions, such as the integration of stem cells and growth factors with specialized scaffolds, offer innovative solutions for tendon regeneration. Various stem cell populations, including mesenchymal stem cells (MSCs), tendon-derived stem cells (TDSCs), and perinatal stem cells (PSCs), have demonstrated potential for assisting in tendon repair. However, significant challenges persist regarding ethical considerations, safety protocols, and treatment standardization.
Conclusions: Stem cell therapy represents a promising frontier in tendon healing, with growing preclinical and clinical support for its regenerative efficacy.
Keywords: Tendon; regeneration; secretomes; stem cell; tendon-derived mesenchymal stem cell (tendon-derived MSC).
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