Piezoelectric Biointerfaces for Tendon Regeneration: Mechanisms, Materials, and Therapeutic Strategies

ABSTRACT Tendon injuries remain clinically challenging due to slow healing, fibrotic scarring, and limited functional recovery. Recent studies have revealed that native tendons possess intrinsic piezoelectric properties, suggesting that electrical cues play an important role in their regenerative processes. Building on this physiological insight, piezoelectric materials have emerged as promising candidates for self‐powered and localized stimulation of tendon healing. This review integrates advances in mechanobiology and materials science to provide a comprehensive perspective on the design and application of piezoelectric biointerfaces for tendon regeneration. We first discuss how electromechanical stimulation influences tenocyte behavior, extracellular matrix remodeling, angiogenesis, and immune modulation. Next, we systematically compare inorganic, organic, and composite piezoelectric materials, focusing on how their structural characteristics and electromechanical properties align with tendon‐specific regenerative needs. Finally, we summarize progress in therapeutic platforms including scaffolds, wearable patches, and implantable sensors, and outline future directions such as artificial intelligence–guided closed‐loop stimulation, passively driven long‐term therapy, and integrated approaches combining electrical cues with drug and gene delivery. This review aims to guide the development of intelligent, self‐sustaining systems for next‐generation tendon repair.