Anterior cruciate ligament reconstruction using a composite collagenous prosthesis

Dunn, Michael G.; Tria, Alfred J.; Kato, Yasushi; Bechler, J R; Ochner, Robert S.; Zawadsky, Joseph P.; Silver, Frederick H.

doi:10.1177/036354659202000504

Cited by 126 publications

(74 citation statements)

References 29 publications

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“…In the early 1990s Dunn et al [63] reported initial work on the development of a ligament prosthesis involving a collagenous ACL prosthesis [63]. Results showed inconsistent neoligament formation and significant weakening of the prosthesis in a rabbit model.…”

Section: Scaffolds For Tissue Engineeringmentioning

confidence: 99%

Silk-based biomaterials

et al. 2003

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Silk from the silkworm, Bombyx mori, has been used as biomedical suture material for centuries. The unique mechanical properties of these fibers provided important clinical repair options for many applications. During the past 20 years, some biocompatibility problems have been reported for silkworm silk; however, contamination from residual sericin (glue-like proteins) was the likely cause. More recent studies with well-defined silkworm silk fibers and films suggest that the core silk fibroin fibers exhibit comparable biocompatibility in vitro and in vivo with other commonly used biomaterials such as polylactic acid and collagen. Furthermore, the unique mechanical properties of the silk fibers, the diversity of side chain chemistries for 'decoration' with growth and adhesion factors, and the ability to genetically tailor the protein provide additional rationale for the exploration of this family of fibrous proteins for biomaterial applications. For example, in designing scaffolds for tissue engineering these properties are particularly relevant and recent results with bone and ligament formation in vitro support the potential role for this biomaterial in future applications. To date, studies with silks to address biomaterial and matrix scaffold needs have focused on silkworm silk. With the diversity of silk-like fibrous proteins from spiders and insects, a range of native or bioengineered variants can be expected for application to a diverse set of clinical needs. r

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Section: Scaffolds For Tissue Engineeringmentioning

confidence: 99%

Silk-based biomaterials

et al. 2003

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“…Few attempts at creating a bioengineered ACL (bACL) have been reported (Dunn et al 1992(Dunn et al , 1993(Dunn et al , 1994. A drawback of Dunn's approach (Dunn et al 1994) is that the matrix of the graft cannot be quickly degraded, and its remodelling is impaired.…”

Section: Introductionmentioning

confidence: 99%

Torn ACL: A New Bioengineered Substitute Brought from the Laboratory to the Knee Joint

Goulet

Rancourt

Cloutier

et al. 2004

Applied Bionics and Biomechanics

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Anterior cruciate ligament (ACL) injuries occur at an annual rate of 120 000 in the USA, and many need reconstructive surgery. We report successful results at 1-13 months following implantation of bioengineered ACL (bACL) in goats. A bACL has been developed using autologous ACL cells, a collagen matrix and bone plugs. The extremities of the bACL were fully integrated into the femur and tibia of the host. Vascularisation of the grafts was extensive 1 month post-surgery and improved with time. At 6 months postgrafting, histological and ultrastructural observations demonstrated a highly organised ligamentous structure, rich in type I collagen fibres and fibroblasts. At the implants' insertion sites, characteristic fibrocartilage was observed having well aligned chondrocytes and collagen fibrils. After a year, mechanical rupture of the grafts demonstrated a major gain in strength. Eventual applications of this new technology in humans include multiple uses in orthopaedic, dental and reconstructive surgeries.

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“…These stages are hydration, depolymerization, loss of mass integrity, absorption, and elimination. This polymer was chosen because of its mechanical retention and its in vitro cellular response to primary rabbit ACL cells (6,(11)(12)(13)(14).Rabbits are one of the most commonly used animals for orthopedic surgery in vivo studies (1,(15)(16)(17)(18)(19)(20)(21)(22)(23)(24). Adult New Zealand White rabbits were used in this study because rabbits are relatively high-level vertebrates, having a size that enables surgical operations, convenient histology, and mechanical analysis.…”

mentioning

confidence: 99%

“…Several groups have explored ligament-like scaffolds with collagen fibers, silk, biodegradable polymers and composites with limited success (1)(2)(3)(4)(5)(6). During this study, we fabricated an absorbable polyL-lactide (PLLA) 3D, braided TEL replacement capable of supporting the growth and phenotypic expression of cells when seeded in vitro.…”

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confidence: 99%

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Biomimetic tissue-engineered anterior cruciate ligament replacement

Cooper

Sahota

Gorum

et al. 2007

Proc. Natl. Acad. Sci. U.S.A.

173

128

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There are >200,000 anterior cruciate ligament (ACL) ruptures each year in the United States, and, due to the poor healing properties of the ACL, surgical reconstruction with autograft or allograft tissue is the current treatment of these injuries. To regenerate the ACL, the ideal matrix should be biodegradable, porous, and exhibit sufficient mechanical strength to allow formation of neoligament tissue. Researchers have developed ACL scaffolds with collagen fibers, silk, biodegradable polymers, and composites with limited success. Our group has developed a biomimetic ligament replacement by using 3D braiding technology. In this preliminary in vivo rabbit model study for ACL reconstruction, the histological and mechanical evaluation demonstrated excellent healing and regeneration with our cell-seeded, tissue-engineered ligament replacement.biomaterials ͉ regenerative medicine T his study was conducted to evaluate the performance of a polymeric 3D braided fibrous tissue-engineered anterior cruciate ligament (ACL) replacement for use in ACL reconstruction. The feasibility of this approach was investigated by comparison of cell-seeded and unseeded tissue-engineered ligaments (TELs) with a rabbit model. The key concepts investigated were (i) the in vivo response of allograft cells seeded onto TELs, (ii) the effect of porosity and pore interconnectivity on cell and collagen infiltration, (iii) the capability of the implant to allow for vascularization, and (iv) the capability of the implant to maintain mechanical function and to transfer load to the neoligament.Several groups have explored ligament-like scaffolds with collagen fibers, silk, biodegradable polymers and composites with limited success (1-6). During this study, we fabricated an absorbable polyL-lactide (PLLA) 3D, braided TEL replacement capable of supporting the growth and phenotypic expression of cells when seeded in vitro. There have been several published observations of favorable PLLA device interactions in animal and human clinical studies (2, 4, 7-10). The degradation of PLLA from a chemical standpoint in vivo can be categorized into five stages (2, 7). These stages are hydration, depolymerization, loss of mass integrity, absorption, and elimination. This polymer was chosen because of its mechanical retention and its in vitro cellular response to primary rabbit ACL cells (6,(11)(12)(13)(14).Rabbits are one of the most commonly used animals for orthopedic surgery in vivo studies (1,(15)(16)(17)(18)(19)(20)(21)(22)(23)(24). Adult New Zealand White rabbits were used in this study because rabbits are relatively high-level vertebrates, having a size that enables surgical operations, convenient histology, and mechanical analysis. In addition, there was data on ACL reconstruction in rabbits with bone-patellar tendon-bone autografts (the gold standard for human reconstructions) that could be used to compare with our tissue engineered ligament results (20).The goal of this investigation was to develop and study a tissue-engineered ACL replacement that could e...

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Anterior cruciate ligament reconstruction using a composite collagenous prosthesis

Cited by 126 publications

References 29 publications

Silk-based biomaterials

Silk-based biomaterials

Torn ACL: A New Bioengineered Substitute Brought from the Laboratory to the Knee Joint

Biomimetic tissue-engineered anterior cruciate ligament replacement

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