Which of the following is a limitation of the tendon healing process?

Misalignment of collagen fibers is a recognized limitation of the tendon healing process. During the natural healing of tendons, collagen synthesis occurs, but the newly formed collagen fibers may not align properly with the existing tendon structure. Proper alignment is crucial because tendons are designed to withstand tensile loads and their strength is primarily derived from the parallel arrangement of collagen fibers. When these fibers are misaligned, the mechanical properties of the tendon can be compromised, leading to a reduced ability to withstand stress and increased risk of reinjury.

Additionally, this misalignment can result in a weaker and less functional tendon repair, as the ordered structure that provides optimal mechanical strength is disrupted. This misalignment contrasts with the organized structure typical of healthy tendons, thus inhibiting effective functional recovery. Understanding this aspect of tendon healing can guide approaches in tissue engineering to enhance repair outcomes by creating scaffolds that promote better collagen alignment and organization.