Fiber-reinforced tissues of the musculoskeletal system, including tendon, ligament, intervertebral disc, and the knee meniscus function to transmit the high mechanical forces that arise with locomotion. As these tissues operate under demanding mechanical regimes, their structure and composition are optimized to enable these activities and to resist damage with repeated use. Hallmarks of these dense fibrous tissues include a high collagen content organized along a prevailing fiber direction that is generally coincident with the principal loading direction, as well as a lack of vascularity after skeletal maturation. While these characteristics enable function, they also predispose these tissues to a poor healing response subsequent to injury.

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