Due to their lack of sufficient vascularization, ligament and tendon healing can be lengthy and cumbersome. Proliferative therapy, or prolotherapy, is a somewhat controversial alternative treatment for these injuries that involves the injection of a solution that causes initial small-scale cell damage to induce a robust injury response for tissue healing. The combination of proliferative therapy with carbon nanostructures to produce a living composite ligament may significantly improve healing and stability of damaged ligaments and tendons. While the prolotherapy would induce a healing response that causes the fibroblasts in the tissue to produce new collagen, the addition of the nanostructures could immediately improve strength; preventing further injury and further strengthening the tissue once it has been healed by serving as a constant irritant to fibroblasts to produce structural ECM. In several in vitro studies, the cellular viability of rat patellar tendon fibroblasts in response to the different treatments was measured. After treatment, cell populations experienced increases in cellular viability. The results of these basic studies show the potential of prolotherapy and carbon nanostructures in ligament and tendon healing at a fundamental, cellular level. They also point to another mechanism for tissue healing after prolotherapy that is separate from the body's wound healing cascade.