Three-Dimensional Engineered Bone–Ligament–Bone Constructs for Anterior Cruciate Ligament Replacement

The anterior cruciate ligament (ACL), a major stabilizer of the knee, is commonly injured. Because of its intrinsic poor healing ability, a torn ACL is usually reconstructed by a graft. We developed a multi-phasic, or bone?ligament?bone, tissue-engineered construct for ACL grafts using bone marrow stromal cells and sheep as a model system. After 6 months in vivo, the constructs increased in cross section and exhibited a well-organized microstructure, native bone integration, a functional enthesis, vascularization, innervation, increased collagen content, and structural alignment. The constructs increased in stiffness to 52% of the tangent modulus and 95% of the geometric stiffness of native ACL. The viscoelastic response of the explants was virtually indistinguishable from that of adult ACL. These results suggest that our constructs after implantation can obtain physiologically relevant structural and functional characteristics comparable to those of adult ACL. They present a viable option for ACL replacement.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/98477/1/ten%2Etea%2E2011%2E0231.pd

Bone-tendon and bone-ligament interface

Reconstruction or repair of ligaments and tendons to bone, following injury, to improve joint function is a very common surgical procedure in orthopedics. The most common surgical ligament reconstruction in humans is anterior cruciate ligament (ACL) reconstruction. Because ACL is not amenable to repair after tear, replacement of the ligament using autograft or allograft tissue is currently the treatment of choice for young and active patients. On the other hand, surgical reattachment to bone is the most reliable treatment in case of rotator cuff tendon tears. Tendon grafting or repair to bone is performed during hand, foot, and ankle surgery. Nowadays, ACL reconstruction and repair of rotator cuff tendon tears are the most commonly performed surgical procedures for soft tissue injuries in orthopedics. © 2014 Springer-Verlag London. All rights are reserved