From structural mimicry to functional regeneration: the evolving role of electrospun nanofibrous scaffolds in tendon tissue engineering

Tendon injuries present significant clinical challenges due to limited self-healing capacity and structural complexity. Conventional therapeutic approaches, including sutures, autografts, allografts, and synthetic implants, frequently fall short in terms of complications, insufficient biocompatibility, or mechanical mismatch, which often leads to functional impairment. In contrast, electrospun nanofibrous scaffolds demonstrate regenerative potential through their biomimetic extracellular matrix architecture. Here, this review introduces the structural hierarchy and biomechanical properties of tendons, current treatment strategies for tendon injuries and recent advances of electrospinning scaffolds for tendon repair. The fundamental principles of electrospinning and advanced fabrication techniques to create oriented, multilayer, composite, and hybrid scaffolds that replicate tendon anisotropy and complexity were highlighted. Subsequently, functionalization strategies such as cell loading, the incorporation of bioactive molecules (e.g., growth factors, platelet-rich plasma, anti-inflammatory agents, and extracellular matrix-regulating proteins), and integration of functional nanomaterials have been used to promote tenocyte adhesion, migration, and proliferation; stem cell tenogenesis; extracellular matrix deposition and remodeling; as well as tissue regeneration. This review highlights the applications of electrospun nanofibrous scaffolds in tendon repair and regeneration, and provides insightful perspectives for the future design and development of electrospinning-based tendon tissue engineering scaffolds.