**7. Conclusion**

Tissue engineering of tendon substitutes and grafts is a viable option to close critical size defects. The choice of a suitable scaffold material, natural or synthetic, is a decision which should be based on biomechanical baseline values of native tendon tissues and which will direct/affect biocompatibility, cell attachment, or incorporation of factors that support the healing process. Cell seeding and cultivation may be performed under static conditions as well as in dynamic systems using bioreactors. Bioreactors offer perfusion flow resulting in shear stress; additional mechanical stimulation by stretching the cell-seeded TEC may help to improve the mechanical characteristics of the TEC and trigger the desired differentiation if stem cells are involved. Growth factors incorporated in TECs may also support the healing process of the lacerated tendon tissue.
