Biomechanical Forces in the Tissue Engineering and Regeneration of Shoulder, Hip, Knee, and Ankle Joints

This review examines the role of biomechanical forces in the tissue engineering and regeneration of load-bearing joints, including the shoulder, hip, knee, and ankle. The authors synthesize current knowledge on how tensile, compressive, shear, hydrostatic, and cyclic loading influence the structure, function, and healing of tendons, ligaments, and articular cartilage. Emphasis is placed on the importance of reproducing physiologically relevant mechanical environments using bioreactors to guide stem cell differentiation, extracellular matrix deposition, and functional tissue formation. The review highlights current limitations in bioreactor design and identifies key parameters—strain magnitude, frequency, duration, and loading mode—that must be optimized to advance regenerative therapies for joint tissues.