Injectable human tendon extracellular matrix via isopropanol-assisted delipidation and mild decellularization for tendon regeneration.

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Tendon injuries remain a major clinical challenge due to their limited intrinsic healing capacity and the shortcomings of current treatment options. Extracellular matrix (ECM)-based approaches are promising; however, most clinically available injectable ECMs are xenogeneic, raising concerns about immunogenicity, pathogen transmission, and limited durability. Human-derived injectable ECMs have recently gained attention, yet conventional solubilization-based preparations often disrupt native architecture and compromise biological function. Here, we present an injectable decellularized human tendon (DHT) produced by a dual-step isopropanol (IPA)-assisted delipidation combined with mild decellularization. This process effectively removed lipids and cells while preserving ultrastructure, collagen organization, and key growth factors, with no cytotoxic residues detected. Notably, instead of chemical solubilization, injectability was achieved by micropulverization and hydration, enabling minimally invasive delivery while retaining structural integrity and native ECM cues. In vitro studies demonstrated that injectable DHT supported the viability and proliferation of human tenocytes and promoted tenogenic differentiation of human adipose-derived stem cells. In a rat Achilles tendon injury model, injectable DHT significantly enhanced ECM remodeling, neovascularization, and functional ten

Evidence level

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

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