Hydrogels form sustainable source for tendon-to-bone healing: Materials, mechanisms and translational design

Injuries to the tendon-to-bone interface (TBI) represent a major clinical challenge because the natural healing response typically produces scar tissue with poor mechanical properties, failing to reconstruct the original fibrocartilaginous gradient. Although hydrogels have been widely recognized as promising scaffolds for regenerative medicine, increasing attention has recently been directed toward the development of sustainable and environmentally friendly biomaterials in alignment with the global “One Health” concept. This review provides a systematic overview of the critical functions that sustainable hydrogels derived from renewable sources in TBI repair. These environmentally conscious materials exhibit several favorable characteristics, including green and low-impact manufacturing processes, good biocompatibility, and intrinsic bioactivity. In the context of TBI regeneration, sustainable hydrogels may help modulate the local microenvironment and provide spatially organized biochemical and biophysical cues to support region-specific tissue regeneration. Moreover, through the application of advanced green crosslinking strategies and hybrid composite designs, these hydrogels can potentially achieve mechanical properties favorable for dynamic tissue integration, such as enhanced fatigue resistance, fracture toughness, and wet-tissue adhesion. Collectively, sustainable hydrogels represent a promising platform for future orthopedic biomaterials and may offer new opportunities for promoting biologically functional TBI regeneration while supporting environmental sustainability.