Objective The goal of this study was to develop a decellularized tendon scaffold(DTS)and repopulate it with adipose-derived stem cells(ADSCs)assisted by low air pressure(LP).Methods The porcine superficial flexor tendons were processed into the DTSs using a combination of physical,chemical,and enzymatic treatments.The effectiveness of decellularization was verified by histological analysis and DNA quantification.The properties of the DTSs were evaluated by quantitative analysis of biochemical characterization,porosimetry,in vitro biocompatibility assessment,and biomechanical testing.Subsequently,the ADSCs-DTS complexes were constructed via cell injection assisted by LP or under atmospheric pressure.The differences in cell distribution,biomechanical properties,and the total DNA content were compared by histological analysis,biomechanical testing,and DNA quantification,respectively.Results Histological analysis confirmed that no cells or condensed nuclear materials were retained within the DTSs with widened interfibrillar space.The decellularization treatment resulted in a significant decrease in the content of DNA and glycosaminoglycans,and a significant increase in the porosity.The DTSs were cytocompatible in vitro and did not show reduced collagen content and inferior biomechanical properties compared with the fresh-frozen tendons.The assistance of LP promoted the broader distribution of cells into the adjacent interfibrillar space and cell proliferation in DTSs.The biomechanical properties of the scaffolds were not significantly affected by the recellularization treatments.Conclusion A novel LP-assisted approach for the construction of cells-DTS complex was established,which could be a methodological foundation for further bioreactor and in vitro studies.
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