Recent Advancements in Ligament Tissue Engineering: The Use of Various Techniques and Materials for ACL Repair

Freeman, Joseph W.; Kwansa, Albert L.

doi:10.2174/1874764710801010018

Cited by 35 publications

(31 citation statements)

References 41 publications

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“…The biomaterials commonly used are silk, a variety of polymers (especially polyhydroxyesters), and natural substrates such as collagen, gelatine, small intestinal submucosal extracellular matrix, and even decellularised ligaments [5–7, 17, 23, 25, 34, 42, 43]. In a study by Ouyang et al, the adhesion, proliferation, and morphology of rabbit ACL cells and MSCs were investigated using different biodegradable polymeric films.…”

Section: Response Of Cells To Different Biomaterials In Ligament Tmentioning

confidence: 99%

Ligament Tissue Engineering and Its Potential Role in Anterior Cruciate Ligament Reconstruction

Yates

Rupani

Foley

et al. 2012

Stem Cells International

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Tissue engineering is an emerging discipline that combines the principle of science and engineering. It offers an unlimited source of natural tissue substitutes and by using appropriate cells, biomimetic scaffolds, and advanced bioreactors, it is possible that tissue engineering could be implemented in the repair and regeneration of tissue such as bone, cartilage, tendon, and ligament. Whilst repair and regeneration of ligament tissue has been demonstrated in animal studies, further research is needed to improve the biomechanical properties of the engineered ligament if it is to play an important part in the future of human ligament reconstruction surgery. We evaluate the current literature on ligament tissue engineering and its role in anterior cruciate ligament reconstruction.

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Section: Response Of Cells To Different Biomaterials In Ligament Tmentioning

confidence: 99%

Ligament Tissue Engineering and Its Potential Role in Anterior Cruciate Ligament Reconstruction

Yates

Rupani

Foley

et al. 2012

Stem Cells International

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“…Ligaments are viscoelastic tissues composed primarily of collagen (Types I, III, and V), elastin, proteoglycans (decorin, hyaluronan, biglycan, fibromodulin, lumican, epiphycan and keratocan), water, and cells (Dugan et al, 2006;Freeman and Kwansa, 2008;Iozzo and Murdoch, 1996;Iwasaki et al, 2008;Laurencin and Freeman, 2005;Scott, 1993;Silver et al, 2003). These components give ligaments unique properties.…”

Section: Introductionmentioning

confidence: 99%

“…These components give ligaments unique properties. Proteoglycans such as decorin align collagen fibrils during development (Dugan et al, 2006;Freeman and Kwansa, 2008;Iozzo and Murdoch, 1996;Iwasaki et al, 2008;Laurencin and Freeman, 2005;Scott, 1993;Silver et al, 2003) and cause ligaments to swell with water, leading to viscous stress dissipation (Dugan et al, 2006;Freeman and Kwansa, 2008;Iozzo and Murdoch, 1996;Iwasaki et al, 2008;Laurencin and Freeman, 2005;Scott, 1993;Silver et al, 2003).…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of a hydrogel–fiber composite for ACL tissue engineering

Freeman

Woods

Cromer

et al. 2011

Journal of Biomechanics

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“…1 The objective mechanical stability of a reconstructed ACL ranges from 85% to 90%, 2 and this has correlated poorly with functional outcome; lack of proprioception is thought to be one of the reasons for poor correlation. [3][4][5][6][7] Furthermore, tibial-side fixation of the free graft has been observed to be the weakest link in the overall stiffness of the construct of the reconstructed ACL.…”

mentioning

confidence: 99%

Anterior Cruciate Ligament Reconstruction Using Hamstring Tendon Autograft With Preserved Insertions

Gupta

Bahadur

Malhotra

et al. 2016

Arthroscopy Techniques

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We present a technique for anterior cruciate ligament (ACL) reconstruction using hamstring tendon autograft with preserved tibial insertions. The tendons, harvested with an open-ended tendon stripper while their tibial insertions are preserved, are looped around to prepare a quadrupled graft. The femoral tunnel is drilled independently through a transportal technique, whereas the tibial tunnel is drilled in a standard manner. The length of the quadrupled graft and loop of the RetroButton is adjusted so that it matches the calculated length of both tunnels and the intra-articular part of the proposed ACL graft. After the RetroButton is flipped, the graft is manually tensioned with maximal stretch on the free end, which is then sutured to the other end with preserved insertions. We propose that preserving the insertions is more biological and may provide better proprioception. The technique eliminates the need for a tibial-side fixation device, thus reducing the cost of surgery. Furthermore, tibial-side fixation of the free graft is the weakest link in the overall stiffness of the reconstructed ACL, and this technique circumvents this problem. Postoperative mechanical stability and functional outcome with this technique need to be explored and compared with those of ACL reconstruction using free hamstring autograft.T he most common surgical treatment for an anterior cruciate ligament (ACL)edeficient knee is reconstruction of the ligament using an autograft, either a quadrupled semitendinosus and gracilis (STG) tendon free hamstring graft or a free boneepatellar tendonebone graft.1 The objective mechanical stability of a reconstructed ACL ranges from 85% to 90%, 2 and this has correlated poorly with functional outcome; lack of proprioception is thought to be one of the reasons for poor correlation.3-7 Furthermore, tibial-side fixation of the free graft has been observed to be the weakest link in the overall stiffness of the construct of the reconstructed ACL. 8,9 We hypothesized that using a technique that preserves the insertions of the hamstring tendons on the tibial side would eliminate the disadvantages of a free graft, such as poor proprioception, tibial-side fixation being the weakest link in the overall construct, and the added cost of using a tibial-side fixation device for a free graft.

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Recent Advancements in Ligament Tissue Engineering: The Use of Various Techniques and Materials for ACL Repair

Cited by 35 publications

References 41 publications

Ligament Tissue Engineering and Its Potential Role in Anterior Cruciate Ligament Reconstruction

Ligament Tissue Engineering and Its Potential Role in Anterior Cruciate Ligament Reconstruction

Evaluation of a hydrogel–fiber composite for ACL tissue engineering

Anterior Cruciate Ligament Reconstruction Using Hamstring Tendon Autograft With Preserved Insertions

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