中国组织工程研究

中国组织工程研究 ›› 2026, Vol. 30 ›› Issue (26): 6923-6929.doi: 10.12307/2026.828

• 生物材料综述 biomaterial review • 上一篇    下一篇

3D生物打印与肌腱修复：应用进展和未来方向

刘学淼1，2，张玉昌1，2，张卫国1，田  康1，王  星2   

  1. 1大连医科大学附属第一医院关节外科与运动医学科，辽宁省大连市  116000；2中国科学院化学研究所，北京市  100190
  • 接受日期:2026-01-01 出版日期:2026-09-18 发布日期:2026-03-16
  • 通讯作者: 王星，博士，副研究员，中国科学院化学研究所，北京市 100190
  • 作者简介:刘学淼，男，1996年生，山东省聊城市人，回族，在读博士，主要从事关节外科与运动医学方面的研究。
  • 基金资助:
    国家自然科学基金项目(52373162)，项目负责人：王星

Three-dimensional bioprinting and tendon repair: application advances and future directions 

Liu Xuemiao1, 2, Zhang Yuchang1, 2, Zhang Weiguo1, Tian Kang1, Wang Xing2   

  1. 1Department of Joint Surgery and Sports Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian 116000, Liaoning Province, China; 2Institute of Chemistry, Chinese Academy of Sciences, Beijing 100190, China
  • Accepted:2026-01-01 Online:2026-09-18 Published:2026-03-16
  • Contact: Wang Xing, PhD, Associate researcher, Institute of Chemistry, Chinese Academy of Sciences, Beijing 100190, China
  • About author:Liu Xuemiao, Doctoral candidate, Department of Joint Surgery and Sports Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian 116000, Liaoning Province, China; Institute of Chemistry, Chinese Academy of Sciences, Beijing 100190, China
  • Supported by:
    National Natural Science Foundation of China, No. 52373162 (to WX)

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摘要：

文题释义：
3D生物打印：是一种增材制造技术，通过逐层打印生物材料(如细胞、支架材料等)精确构建三维结构。该技术能够实现高度定制，精确复制人体组织或器官的微观结构与功能，为再生医学、组织工程及个性化医疗提供了创新的解决方案。通过控制材料的分布与结构，3D生物打印能够在多种应用场景中满足复杂的生物功能需求。 
肌腱修复：是指通过医学手段对急慢性损伤的肌腱进行治疗和修复，以恢复其正常功能的过程。肌腱修复核心涉及三大关键区域：①肌肉-肌腱界面：作为肌肉收缩力向肌腱传递的起始界面，通过扇状互锁胶原与弹性蛋白实现力学过渡，损伤后易瘢痕化致传导效率下降；②肌腱本体：由高度定向的Ⅰ型胶原纤维组成，承担主要力学负荷，但其低细胞密度与乏血管特性导致再生紊乱、力学性能弱；③肌腱-骨骼界面：通过胶原类型(Ⅰ型→Ⅱ型→Ⅹ型)与矿化梯度实现软-硬组织力学适配，损伤后纤维软骨再生障碍易引发再损伤。修复需针对性重建各区域结构与功能连续性，恢复运动力学传导链。

背景：目前，3D生物打印技术凭借多尺度结构可控性与功能集成化设计能力已成为肌腱组织工程的前沿解决方案。
目的：系统综述3D打印技术在肌腱修复中的最新研究进展。
方法：以“3D printing，bioink，Myotendinous junction，tendon repair，Tendon-bone junction， Biomimetic scaffold”为关键词在PubMed和Web of Science数据库进行文献检索，以“3D打印，生物墨水，肌肉-肌腱界面，肌腱修复，腱骨界面，生物仿生支架”为关键词在中国知网中检索文献。排除与主题关联性不强的文章，最终纳入109篇文献进行综述。 
结果与结论：3D打印技术通过多材料集成和可控的仿生结构设计有效复现了肌腱的多层级结构，主流技术(如熔融电纺丝、挤出式打印等)在纤维排列、界面模拟及动态调控中发挥差异化优势，构建肌肉-肌腱界面处力学过渡层与肌腱-骨骼界面处四区渐变结构；生物墨水功能化创新(免疫调节材料、跨物种供氧支架等)及多技术协同(定向纤维沉积+光固化增强)提升支架生物活性与力学-生物学耦合能力；在愈合全周期(炎症期支撑、增殖期引导、重塑期调控)实现从分子到宏观的精准干预，优化胶原排列与修复力学性能。针对肌肉-肌腱界面处、肌腱本体、肌腱-骨骼界面处的差异化修复策略(多材料梯度、定向纤维、梯度支架)已取得进展。尽管面临分辨率-效率矛盾、材料匹配不足等挑战，3D打印技术仍为肌腱修复提供了从结构仿生到功能再生的新策略，未来智能材料(光热/压电)与多模态技术(4D打印、类器官)融合有望推动动态功能再生，为界面修复提供技术参考。
https://orcid.org/0000-0002-8978-909X(刘学淼)

中国组织工程研究杂志出版内容重点：生物材料；骨生物材料；口腔生物材料；纳米材料；缓释材料；材料相容性；组织工程

关键词: 3D打印, 生物墨水, 肌肉-肌腱界面, 肌腱本体, 腱骨界面, 梯度结构, 仿生支架

Abstract: BACKGROUND: Currently, three-dimensional (3D) bioprinting technology, with its controllable multi-scale structure and functional integration design capabilities, has become a cutting-edge solution for tendon tissue engineering. 
OBJECTIVE: To systematically summarize the latest research progress of 3D bioprinting technology in tendon repair. 
METHODS: Using the keywords “3D printing, bioink, myotendinous junction, tendon repair, tendon-bone junction, bionic scaffold,” literature searches were conducted in the PubMed and Web of Science databases, as well as in the China National Knowledge Infrastructure (CNKI) with the same keywords. Articles with weak relevance to the topic were excluded, and 109 articles were ultimately included for review.
RESULTS AND CONCLUSION: 3D bioprinting technology, through multi-material integration and controllable biomimetic structure design, effectively reproduces the multi-level structure of tendons. Mainstream technologies (such as melt electrospinning and extrusion printing) play differentiated advantages in fiber arrangement, interface simulation, and dynamic regulation, constructing mechanical transition layers at the muscle-tendon interface and four-zone gradient structures at the tendon-bone interface. Functional innovations in bioinks (such as immunomodulatory materials and cross-species oxygen supply scaffolds) and multi-technology synergy (directional fiber deposition + photo-curing enhancement) enhance the biological activity and mechanical-biological coupling ability of the scaffolds. Throughout the entire healing cycle (support in the inflammatory phase, guidance in the proliferative phase, and regulation in the remodeling phase), it achieves precise intervention from the molecular to the macroscopic level, optimizing collagen arrangement and repair mechanical properties. Differentiated repair strategies for the muscle-tendon interface, tendon body, and tendon-bone interface (such as multi-material gradients, directional fibers, and gradient scaffolds) have made progress. Despite challenges such as the resolution-efficiency contradiction and insufficient material matching, 3D printing technology still provides new strategies from structural biomimicry to functional regeneration for tendon repair. The integration of smart materials (such as photothermal/piezoelectric) and multi-modal technologies (such as 4D printing and organoids) in the future is expected to promote dynamic functional regeneration and provide technical references for interface repair.

Key words: 3D printing, bioink, myotendinous junction, tendon body, tendon-bone junction, gradient structures, bionic scaffolds

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