Programming Ordered Tissue Reconstruction via Artificial Bionic Tendon Sheath for Tendinopathy Treatment

Excessive interface friction and advanced glycation end products (AGEs) disrupt collagen ordered deposition, promoting scar formation in tendinopathies. Inspired by tendon sheath anatomy, we developed a bionic bilayer nano-membrane via electrospinning and photocrosslinking to initiate the directional and orderly regeneration process of tendon tissue. The lubricating layer (PP), containing phosphatidylserine (PS), reduces frictional stress, while the regenerative layer (GM/GV), composed of gelatin methacrylate (GM) and vanillin-modified gelatin (GV), scavenges ROS and mitigates AGEs-induced collagen disorder deposition. This parallel bilayer structure guides tendon cell alignment and promotes ordered collagen deposition. Additionally, vanillin suppresses the AGEs/TGF-β/Smad pathway, reducing scar formation and tissue adhesion. In vitro/in vivo tests showed a fivefold decrease in coefficient of friction (COF) and a tenfold increase in Achilles tendon function index (AFI) compared to the PCL and normal groups, respectively. The PP@GM/GV membrane, regulated by mechano-biochemical coupling factors, offers a promising strategy for tendinopathy repair, and holds significant potential for clinical translation in guiding functional tendon regeneration and improving patient outcomes. Graphical