Current Progress in Tendon and Ligament Tissue Engineering

Abstract

BACKGROUND: Tendon and ligament injuries accounted for 30% of all musculoskeletal consultations with 4 million new incidences worldwide each year and thus imposed a significant burden to the society and the economy. Damaged tendon and ligament can severely affect the normal body movement and might lead to many complications if not treated promptly and adequately. Current conventional treatment through surgical repair and tissue graft are ineffective with a high rate of recurrence. METHODS: In this review, we first discussed the anatomy, physiology and pathophysiology of tendon and ligament injuries and its current treatment. Secondly, we explored the current role of tendon and ligament tissue engineering, describing its recent advances. After that, we also described stem cell and cell secreted product approaches in tendon and ligament injuries. Lastly, we examined the role of the bioreactor and mechanical loading in in vitro maturation of engineered tendon and ligament. RESULTS: Tissue engineering offers various alternative ways of treatment from biological tissue constructs to stem cell therapy and cell secreted products. Bioreactor with mechanical stimulation is instrumental in preparing mature engineered tendon and ligament substitutes in vitro. CONCLUSIONS: Tissue engineering showed great promise in replacing the damaged tendon and ligament. However, more study is needed to develop ideal engineered tendon and ligament.

Multi-layer Scaffolds of Poly(caprolactone), Poly(glycerol sebacate) and Bioactive Glasses Manufactured by Combined 3D Printing and Electrospinning

“…This had a positive effect on the growth of fibroblasts, whose viability was sustained longer in vitro for scaffolds with 10 wt% BGs. The composite scaffolds can find potential applications in tendon and ligament tissue engineering, since they meet the mechanical requirements of native tissues (elastic modulus in the range of 100-300 MPa) [43], in agreement with previous studies [44]. For these specific tissue engineering applications, scaffolds with anisotropic characteristics can be manufactured using the fabrication method discussed in this work.…”

Investigating Commercial Filaments for 3D Printing of Stiff and Elastic Constructs with Ligament-Like Mechanics

“…More effective ligament reconstruction strategies are therefore necessary. The fabrication of scaffolds for tendon and ligament tissue engineering has utilized numerous synthetic biomaterials, such as polycaprolactone, polyglycolic acid, poly(lactic-co-glycolic acid), poly-L-lactide, and polyurethane urea, as well as other techniques: electrospinning, knitting, melt extrusion-based 3D-bioplotting, and 3D braiding [ 13 , 30 ]. The technique of FDM in particular has been used to print different polymers to determine their tensile properties [ 43 ].…”

“…To address shortcomings associated with surgical intervention and the poor healing of the ACL, researchers have explored tissue engineering (TE) and regenerative medicine strategies which aim to combine cells, scaffolds, and biologically active molecules [ 30 ]. 3D-printed scaffolds can be seeded with cells and then implanted into the injured site to allow for growth or regeneration of the tissue [ 28 , 31 , 32 ].…”

Treatment of spinal cord injury with mesenchymal stem cells

“…Traditionally, the regenerative capacity of MSCs was thought to be related to its plasticity to differentiate into neural and glial cells [ 26 , 27 ]. However, recent studies suggested that the therapeutic effect is mostly exerted by their paracrine activity as MSCs have been found to secrete a broad range of bioactive molecules [ 28 ]. MSCs secrete VEGF, HGF, IGF-I, stanniocalcin-1, TGF-β, and GM-CSF that promote the survival of damaged neurons and oligodendrocytes [ 29 , 30 ].…”