The effective repair of tendon injuries represents a significant challenge in the selection of an appropriate regeneration strategy. Meanwhile, umbilical cord-derived mesenchymal stem cells (UC-MSCs) have been employed in the treatment of a range of diseases due to a number of advantageous characteristics, including low immunogenicity, high proliferation and differentiation potential, extensive availability, ease of large-scale production, absence of ethical constraints, and immunomodulatory functions. It has demonstrated considerable clinical application potential and offer a promising avenue for the treatment of tendon injuries. The core strategies may be broadly classified into three categories: direct stem cell injection, transplantation of biological scaffolds with tissue engineering technology, and the use of stem cell-derived products. This review will provide an in-depth analysis of the pathophysiological mechanisms of tendon repair, describe the unique properties of UC-MSCs, and systematically evaluate the advantages and limitations of these treatment strategies, aiming to provide a solid theoretical basis and scientific guidance for the biological research and clinical application of UC-MSCs in the field of tendon repair. The translational potential of this article: Given the low immunogenicity, good biosafety, and strong differentiation potential possessed by UC-MSCs, it is expected to provide a both safe and effective therapeutic option for tendon injuries through certain processing measures, such as combining UC-MSCs with biomaterials or extracting their products. In addition, the extraction process of UC-MSCs is simple and non-invasive, which makes it easy to realize clinical mass production. Therefore, the use of UC-MSCs for tendon repair is significant for clinical translation of tendon injury treatment.
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