BACKGROUND:Adult stem cells are surveillance repositories capable of supplying a renewable source of progenitors for tissue repair and regeneration to maintain tissue homeostasis throughout life.Many tissue-resident stem cells have been identified in situ,which lays the foundation for studying them in their native microenvironment,i.e.the niche.Within the musculoskeletal system,muscle stem cells have been unequivocally identified in the mouse,which have led to considerable advances in understanding their role in muscle homeostasis and regeneration.On the other hand,for bone and tendon progenitor cells,mesenchymal stem cells have been used as the main in vitro cell model as they can differentiate into osteogenic,chondrogenic and tenogenic fates.Despite considerable efforts and employment of mode tools,the in vivo origins of bone and tendon stem cells remain debated.Tendon regeneration via stem cells is understudied and deserves attention as tendon damage is noted for a bleak,time-consuming recovery and the repaired tendon seldom regains the structural integrity and strength of the native,uninjured state.OBJECTIVE:Here we review the past efforts and recent studies toward defining adult tendon stem cells and understanding tendon regeneration instead of tendon development.The focus is on adult tendon resident cells in situ and the uncertainty of their roles in regeneration.METHODS:A systematic literature search using the Pubmed search engine was conducted encompassing the seminal papers in the tendon field.CONCLUSIONS:Investigation of tendon stem cells in situ is in its infancy mainly due to lack of necessary tools and standardized injury model.We propose a concerted effort toward establishing a comprehensive cell atlas of the tendon,making genetic tools and choosing a reliable injury model for coordinated studies among different laboratories.Increasing our basic understanding should aid future therapeutic innovations to shorten and enhance the tendon repair/regeneration process.