Design and characterization of a scaffold for anterior cruciate ligament engineering.

Advances in biomedical engineering have led to an understanding of the human body's capacity for anterior cruciate ligament (ACL) healing if provided the correct impetus--a long-term bioresorbable scaffold that anticipates the defect site's requirements. Tissue engineering an ACL requires a scaffold that can meet multiple and often conflicting mechanical and biological design requirements. The design and characterization of a hydrophilic silk scaffold is presented as an example of the preclinical testing required to fully characterize a scaffold for ACL reconstruction. We hypothesize that by providing a structural scaffold which anticipates ACL repair mechanisms, an "engineered" autologous ligament with excellent functional integrity can be developed by the body itself. Mechanical, biological, and patient-clinician testing demonstrate that the hydrophilic silk scaffold is a mechanically robust, biocompatible, long-term bioresorbable ACL scaffold with demonstrated safety that can be implanted in accordance with standard surgical procedures.