Tendon augmentation grafts: a systematic review

INTRODUCTION: Several biomaterials are available to bridge large tendon defects or reinforce tenuous tendon repairs. METHODS: We performed a comprehensive search of PubMed, Medline, Cochrane, CINAHL, and Embase databases using various combinations of the commercial names of each scaffold and the keywords 'tendon', 'rotator cuff', 'supraspinatus tendon', 'Achilles tendon', 'scaffold', 'biomaterials', 'extracellular matrix', 'substitute', and 'devices' over the years 1966-2009. All articles relevant to the subject were retrieved, and their bibliographies hand searched for further references in the context to biomaterials for tendon repair. RESULTS: Many biomaterials are available for tendon augmentation. Scanty evidence is available for the use of these scaffolds. DISCUSSION: The emerging field of tissue engineering holds the promise to use biomaterials for tendon augmentation. Preliminary studies support the idea that these biomaterials have the ability to provide an alternative for tendon augmentation. However, available data are lacking to allow definitive conclusion on the use of biomaterials for tendon augmentation. Additionally, the prevalence of postoperative complications encountered with their use varies within the different studies. CONCLUSION: Rather than providing strong evidence for or against the use of these materials for tendon augmentation, this study instead generates potential areas for additional prospective investigation.