A Self-Powered Piezo-Bioelectric Device Regulates Tendon Repair-Associated Signaling Pathways through Modulation of Mechanosensitive Ion Channels

This study reports an implantable, self-powered piezo-bioelectric scaffold designed to improve tendon repair by converting physiologic mechanical loading into localized bioelectric cues. The authors fabricate aligned electrospun PVDF-TrFE fibrous scaffolds (with a chemically/topographically analogous non-piezoelectric PTFE control) and show that electromechanical stimulation (EMS) better maintains tendon-cell phenotype in vitro than mechanical stimulation alone, including sustained upregulation of tendon markers (e.g., SCX, TNMD) and differential regulation of mechanosensitive ion channels and signaling pathways (MAPK/ERK, FAK, Wnt/β-catenin, BMP). In a rat Achilles acute injury model, combining moderate treadmill running with the piezoelectric scaffold improved tendon-specific repair signatures and reduced maladaptive pathways (e.g., calcification/osteochondral drift) compared with mechanical-only controls, supporting electromechanical stimulation as a strategy to bias healing toward tendon-specific regeneration.