Additively Manufactured Multiphasic Bone-Ligament-Bone Scaffold for Scapholunate Interosseous Ligament Reconstruction

Vaquette, Cédryck; Bindra, Randy; Baldwin, Jeremy; Ivanovski, Sašo

doi:10.2139/ssrn.3313284

Cited by 6 publications

(19 citation statements)

References 12 publications

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“…The BLB scaffold used in this study was a modification of that developed by Lui and co-workers [27] and is made by 3D-printing of medical grade PCL (PC12 Corbion). The BLB scaffold design is depicted in Fig 2a and 2b in 2D, 3D, Fig 2c and an example fabricated scaffold, respectively.…”

Section: Scaffold Design and Manufacturingmentioning

confidence: 99%

“…We studied the 3D-printed PCL multiphasic scaffold previously developed by our colleagues for animal models (Fig 2, [27]). The goal of reconstruction with a printed multiphasic scaffold is to implant the bone plugs into drilled holes in the scaphoid and lunate with the longitudinal fibers aligned on the dorsal surface of the scapholunate articulation.…”

Section: Plos Onementioning

confidence: 99%

“…Henceforth, the ligament portion will be referred to as the "ligament-scaffold". In-vivo testing on small-and medium-sized animals demonstrated biocompatibility of the BLB, as evidenced by vascularisation and incorporation into the rabbit knee, as well as collagen deposition in the ligament-scaffold and bone formation within bone plugs [27,37]. Despite these promising results from animal studies, use of BLB scaffold in the human wrist remains a non-trivial challenge due to the limited understanding of the physiological conditions of the human wrist, and the interaction between scaffold design and surgical installation.…”

Section: Introductionmentioning

confidence: 97%

“…TE scaffolds produced from a variety of polymers [22,23] should have interconnected pore structure and high porosity to ensure cellular penetration and adequate diffusion of nutrients to cells within the construct and to the extra-cellular matrix formed by these cells [20,24,25]. Additionally, they should have chemical, physical, biological, and adequate mechanical properties to perform as a replaceable frame [20,26,27]. Numerous conventional methods and advanced fabrication techniques have been introduced for scaffold manufacturing to replace tissue or organs employing solvent-casting particulate leaching [28] in combination with melt molding [29], gas foaming [30], and phase-separation [31].…”

Section: Introductionmentioning

confidence: 99%

“…More recently, 3D printing (digital light processing [32], fused deposition modeling [33] and robocasting [34]) have offered better control over the architecture and physical properties of the scaffold, thereby enabling the manufacturing of patient-specific constructs [35,36]. Recently, a multiphasic bone-ligament-bone (BLB) scaffold [27] has been proposed to reconstruct the dorsal SLIL, and which can be 3D-printed using medical grade polycaprolactone (PCL). In this BLB scaffold, the ligament portion was represented by approximately parallel fibers terminating onto orthogonal plugs that interface with bone (Fig 2).…”

Section: Introductionmentioning

confidence: 99%

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Finite element analysis of the performance of additively manufactured scaffolds for scapholunate ligament reconstruction

et al. 2021

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Rupture of the scapholunate interosseous ligament can cause the dissociation of scaphoid and lunate bones, resulting in impaired wrist function. Current treatments (e.g., tendon-based surgical reconstruction, screw-based fixation, fusion, or carpectomy) may restore wrist stability, but do not address regeneration of the ruptured ligament, and may result in wrist functional limitations and osteoarthritis. Recently a novel multiphasic bone-ligament-bone scaffold was proposed, which aims to reconstruct the ruptured ligament, and which can be 3D-printed using medical-grade polycaprolactone. This scaffold is composed of a central ligament-scaffold section and features a bone attachment terminal at either end. Since the ligament-scaffold is the primary load bearing structure during physiological wrist motion, its geometry, mechanical properties, and the surgical placement of the scaffold are critical for performance optimisation. This study presents a patient-specific computational biomechanical evaluation of the effect of scaffold length, and positioning of the bone attachment sites. Through segmentation and image processing of medical image data for natural wrist motion, detailed 3D geometries as well as patient-specific physiological wrist motion could be derived. This data formed the input for detailed finite element analysis, enabling computational of scaffold stress and strain distributions, which are key predictors of scaffold structural integrity. The computational analysis demonstrated that longer scaffolds present reduced peak scaffold stresses and a more homogeneous stress state compared to shorter scaffolds. Furthermore, it was found that scaffolds attached at proximal sites experience lower stresses than those attached at distal sites. However, scaffold length, rather than bone terminal location, most strongly influences peak stress. For each scaffold terminal placement configuration, a basic metric was computed indicative of bone fracture risk. This metric was the minimum distance from the bone surface to the internal scaffold bone terminal. Analysis of this minimum bone thickness data confirmed further optimisation of terminal locations is warranted.

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Section: Scaffold Design and Manufacturingmentioning

confidence: 99%

Section: Plos Onementioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Finite element analysis of the performance of additively manufactured scaffolds for scapholunate ligament reconstruction

et al. 2021

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Advanced biofabrication strategies for biomimetic composite scaffolds to regenerate ligament‐bone interface

Jiang

Mao

Xiao

et al. 2021

Biosurface and Biotribology

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The natural ligament-bone interface features gradient changes in matrix composition, architecture and cell phenotype, which play critical roles in reliable ligament fixation and smooth loading transfer. Mimicking such organisations in artificial composite tissueengineering scaffolds is important for realising functional fixation between ligament implants and host bones. Here, the authors aim to provide a comprehensive review on the latest strategies to fabricate biomimetic composite scaffolds for the regeneration of ligament-to-bone interface. The biomimetic composite scaffolds are divided into stratified and gradient scaffolds, which are characterised as layer-specific and continuous changes, respectively, in scaffold materials and/or microstructures. Biofabrication strategies for different types of composite scaffolds are summarised. The effects of material/structural changes on cellular morphology, cell differentiation, in vivo osteointegration and multitissue interface regeneration are highlighted. Finally, the potential challenges and future perspectives in engineering biomimetic composite scaffolds for ligament-bone interface regeneration are discussed.

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BMP2 and GDF5 for Compartmentalized Regeneration of the Scapholunate Ligament

et al. 2023

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Background Chronic injuries to the scapholunate ligament (SLIL) alter carpal kinematics and may progress to early degenerative osteoarthritis. To date, there is no consensus for the best method for SLIL reconstruction. This study aims to assess the use of growth factors (bone morphogenetic protein [BMP]2 and growth and differentiation factor 5 [GDF5]) for compartmentalized regeneration of bone and ligament in this multiphasic scaffold in a rabbit knee model. Case Description A total of 100 µg of BMP2 and 30 µg of GDF5 were encapsulated into a heparinized gelatin–hyaluronic acid hydrogel and loaded into the appropriate compartment of the multiphasic scaffold. The multiphasic scaffold was implanted to replace the native rabbit medial collateral ligament (n = 16). The rabbits were randomly assigned to two different treatment groups. The first group was immobilized postoperatively with the knee pinned in flexion with K-wires for 4 weeks (n = 8) prior to sacrifice. The second group was immobilized for 4 weeks, had the K-wires removed followed by a further 4 weeks of mobilization prior to sample harvesting. Literature Review Heterotopic ossification as early as 4 weeks was noted on gross dissection and confirmed by microcomputed tomography and histological staining. This analysis revealed formation of a bony bridge located within and over the ligament compartment in the intra-articular region. Biomechanical testing showed increased ultimate force of the ligament compartment at 4 weeks postimplantation consistent with the presence of bone formation and higher numbers of scaffold failures at the bone–tendon junction. This study has demonstrated that the addition of BMP2 and GDF5 in the bone–ligament–bone (BLB) scaffold resulted in heterotopic bone formation and failure of the ligament compartment. Clinical Relevance The implantation of a three-dimensional-printed BLB scaffold alone demonstrated superior biomechanical and histological results, and further investigation is needed as a possible clinical reconstruction for the SLIL.

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Additively Manufactured Multiphasic Bone-Ligament-Bone Scaffold for Scapholunate Interosseous Ligament Reconstruction

Cited by 6 publications

References 12 publications

Finite element analysis of the performance of additively manufactured scaffolds for scapholunate ligament reconstruction

Finite element analysis of the performance of additively manufactured scaffolds for scapholunate ligament reconstruction

Advanced biofabrication strategies for biomimetic composite scaffolds to regenerate ligament‐bone interface

BMP2 and GDF5 for Compartmentalized Regeneration of the Scapholunate Ligament

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