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REVIEW ARTICLE

Decellularized extracellular matrix bioinks for 3D bioprinting of the tendon–bone interface: From biomimetic gradients to regenerative healing

Zhaowei Zhang1† ,  Hao Chen1† ,  Jinbo Zhang1 ,  Yang Liu1 ,  Xingzhen Li1 ,  Zhennan Gan1 ,  Wenzhong Liu1 ,  Ziteng Zhou1 ,  Zhidong Liang1 ,  Xue Zhao2* ,  Jincheng Wang1 ,  Qing Han1*
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1 Department of Orthopedics, The Second Hospital of Jilin University, Changchun, Jilin , China
2 Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, Jilin , China
†These authors contributed equally to this work.
IJB, 026320342 https://doi.org/10.36922/IJB026320342
Received: 5 August 2026 | Revised: 29 August 2026 | Accepted: 1 September 2026 | Published online: 1 September 2026
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

The tendon–bone interface anchors compliant tendon to rigid bone through continuous gradients in collagen orientation, proteoglycan content, mineralization, and local modulus. Following tendon–bone injury in adults, this spatiotemporal organization is difficult to restore, and repair typically produces a fibrous connection rather than a functional enthesis. The main barrier is not the absence of a single pro-reparative factor but a spatiotemporal mismatch among immune resolution, regional cell identity, matrix maturation, controlled mineralization, and load transfer. Tissue-derived decellularized extracellular matrix (dECM) can retain source-associated matrix cues, while 3D bioprinting enables their controlled spatial placement. However, none of printability, increased lineage-marker expression, or a higher ultimate failure load alone is sufficient to establish functional enthesis regeneration. This review examines how dECM identity is retained during decellularization, solubilization, and printing; how regionalized constructs are designed; and how these strategies may influence cell identity, immune regulation, matrix remodeling, perfusion, and mechanical maturation. Current evidence supports the feasibility of dECM bioprinting for regionalized tissue formation and interface integration, but remains insufficient to establish tissue-specific potency, long-term gradient stability, or neotissue-mediated load transfer after scaffold degradation. We therefore propose a progressive evidence framework comprising material identity, manufacturing fidelity, regional tissue formation, host integration, and load takeover to distinguish proof of concept, enthesis-like tissue formation, and functional regeneration. Future progress will require reproducible, attributable, and translatable evidence generated using physicochemically matched controls, spatiotemporal quantification, and long-term loading models.

Keywords
Tendon–bone interface
Decellularized extracellular matrix
Bioink; 3D bioprinting
Functional gradient
Regeneration assessment
Funding
This work was supported by the National Natural Science Foundation of China (82472460, 82272504), the Department of Science and Technology of Jilin Province (YDZJ202501ZYTS041), and the key training plan for outstanding youth of Jilin University (419070623036).
Conflict of interest
Jincheng Wang is an Editorial Board Member of this journal, but was not in any way involved in the editorial and peer-review process conducted for this paper, directly or indirectly. The authors declare that they have no known competing financial interests or personal relationships that could have influenced the work reported in this paper.
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International Journal of Bioprinting, Electronic ISSN: 2424-8002 Print ISSN: 2424-7723, Published by AccScience Publishing
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