Abstract
As the principal constituent of the extracellular matrix, collagen exhibits significant therapeutic potential in sports medicine, owing to its distinct triple-helical configuration and inherent biocompatibility. This biomaterial serves as a foundational material for scaffolds, membranes, patches and dressings targeting tendon repair, cartilage reconstruction and bone defect remediation. However, its clinical translation was hampered by limitations: poor tensile strength risks mechanical failure under load, immunogenicity from residual epitopes can trigger adverse reactions and rapid enzymatic degradation compromises structural integrity before tissue maturation. This review elucidates current properties and resources of collagen-based biomaterial and critically analyzes its inherent limitations and their clinical consequences. It emphasizes how evolving tissue engineering strategies directly mitigate barriers. Molecular crosslinking and chemical modification are employed to enhance tensile properties and delay degradation, critical for mechanically demanding environments. Composite blending with polymers compensates for mechanical weakness while retaining bioactivity. Advanced processing techniques such as 3D printing and electrospinning enable precise fiber alignment, replicating native tissue anisotropy and improving functional outcomes. Rigorous decellularization protocols further mitigate immunogenicity. This review further examines recent preclinical and clinical progress in collagen-based biomaterials for tendon, ligament, cartilage and bone regeneration, highlighting successful translations and ongoing challenges. Future directions focus on refining these strategies to accelerate the development of next-generation, clinically robust collagen therapies for sports medicine.