一种用于前交叉韧带重建的新型丝 TCP-PEEK 构建体:一种现成的替代物,可替代骨-肌腱-骨自体移植物。

A novel silk-TCP-PEEK construct for anterior cruciate ligament reconstruction: an off-the shelf alternative to a bone-tendon-bone autograft.

机构信息

Department of Orthopaedics, University of Zurich, Balgrist University Hospital, Switzerland. Institute for Biomechanics, ETH Zurich, Switzerland.

出版信息

Biofabrication. 2014 Mar;6(1):015010. doi: 10.1088/1758-5082/6/1/015010. Epub 2014 Mar 4.

Abstract

Bone-tendon-bone autograft represents a gold-standard for anterior cruciate ligament (ACL) reconstruction but at the cost of a secondary surgical site that can be accompanied by functional impairment and discomfort. Although numerous in vitro and in vivo studies have investigated tissue engineering alternatives to autografting, the achievement of a functional histological transition between soft and hard tissue has remained elusive. To bridge this gap we developed and tested a novel multiphase scaffold of silk, tricalcium phosphate (TCP) and polyether ether ketone for ACL reconstruction. We present in vitro biomechanical tests demonstrating that the construct recapitulates native ACL function under typical physiological loads. A pilot in vivo experiment in two pigs with a three-month follow-up showed a robust histological transition between regenerated fibrous tissue and the margins of the bone tunnel, with histological features similar to the native ACL to bone insertion. These histological observations suggest that the construct was stably anchored until TCP incorporation to the host tissues. On the strength of these preliminary results, we conclude that the described approach may offer a promising alternative to autograft for ACL reconstruction. This study thus provides proof for a concept that warrants further development.

摘要

骨-腱-骨自体移植物是前交叉韧带 (ACL) 重建的金标准,但需要进行二次手术,这可能会导致功能障碍和不适。尽管已经有许多体外和体内研究探讨了替代自体移植物的组织工程方法,但仍然难以实现软组织和硬组织之间的功能性组织学转变。为了弥补这一差距,我们开发并测试了一种用于 ACL 重建的新型丝、磷酸三钙 (TCP) 和聚醚醚酮多相支架。我们展示了体外生物力学测试,证明该构建体在典型生理负荷下再现了天然 ACL 的功能。在两头猪中进行了为期三个月的前瞻性初步体内实验表明,在再生纤维组织和骨隧道边缘之间有一个坚固的组织学过渡,其组织学特征与天然 ACL 与骨的插入相似。这些组织学观察表明,在 TCP 与宿主组织结合之前,该构建体已经稳定地固定在原位。基于这些初步结果,我们得出结论,该方法可能为 ACL 重建提供一种有前途的自体移植物替代方法。因此,本研究为进一步开发提供了概念验证。

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