Nanofiber based transformative approaches for tendon regenerative engineering: past, present and future

Tendon injuries present a major clinical challenge due to the tissue's limited regenerative capacity, poor vascularization, and tendency toward fibrotic healing that compromises mechanical function. Surgical and conservative treatments often fail to restore native tendon architecture, leading to high rates of retear, adhesion, and long-term functional impairment. In recent years, tissue engineering strategies have gained increasing attention, with nanofiber-based matrices emerging as promising platforms for functional tendon regeneration. Owing to their structural similarity to native extracellular matrix (ECM), nanofiber scaffolds enable precise control over fiber alignment, porosity, and mechanical properties, which are critical for guiding tenogenic cell behavior and matrix organization.This review summarizes recent advances in nanofiber fabrication techniques, including electrospinning and hybrid nanomanufacturing approaches, and discusses strategies for tailoring scaffold properties through biophysiochemical cues, biological factor delivery, cell incorporation, and nanoparticle functionalization. Special emphasis is placed on multifunctional nanofiber systems that modulate inflammation, promote tenogenic differentiation, enhance tendon - bone interface healing, and minimize scar formation and postoperative adhesion. Finally, current challenges and future directions toward scalable manufacturing, reproducibility, and clinical translation are discussed. Collectively, nanofiber-based matrices represent a versatile and powerful approach for advancing tendon tissue engineering and achieving durable functional repair. Search: PubMed, Google Scholar, through March 2026.