Evaluation of Tissue-engineered Tendon Enthesis Polymer Constructs

Both scientists and clinicians have proposed tissue engineering as the future of medicine. The possibilities for tissue engineering, that is, fabrication of tissues and organs in the laboratory and their translation to patients, appear to be endless, and many believe that this new approach in medicine will result in abolishing many common ailments, injuries, and congenital defects. Injuries to a tendon enthesis, the normal tissue connection between tendon and bone, are of particular concern to clinicians because of their frequency and failure to repair as a result of surgery. While these injuries may not be life threatening, they can certainly limit mobility and reduce the quality of life in those affected individuals. Fabrication of a tendon enthesis by tissue engineering would offer an alternative to the routine of surgery now performed and present potential for treatment and healing of the tissue now unavailable. In the current prospective study, polymer scaffolds created using polycaprolactone (PCL), poly-L lactide (PLLA), or nano-polyglycolic acid (nPGA) were seeded with chondrocytes, tenocytes, and periosteum for the development of cartilage, tendon and bone, respectively, and then implanted into six athymic nude mice for a period of 10 weeks. One group of constructs (scaffolds and cells or tissue together) was tethered to the mice 2 in order to determine if mechanical forces improved or were required for tendon enthesis formation compared to a group of identical implanted constructs that were not tethered. Analysis by histology illustrated a noticeable increase in tissue formation around the area of anticipated enthesis in tethered constructs when compared to constructs that were not tethered. Based on these data, it is believed that mechanical tension (tethering) is required for the formation of a tendon enthesi