Lipner Justin, Boyle John J, Xia Younan, Birman Victor, Genin Guy M, Thomopoulos Stavros
Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, MO, USA; Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO, USA.
Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO, USA.
Acta Biomater. 2017 Aug;58:492-501. doi: 10.1016/j.actbio.2017.05.033. Epub 2017 May 19.
Partially mineralized fibrous tissue situated between tendon and bone is believed to be tougher than either tendon or bone, possibly serving as a compliant, energy absorptive, protective barrier between the two. This tissue does not reform following surgical repair (e.g., rotator cuff tendon-to-bone re-attachment) and might be a factor in the poor outcomes following such surgeries. Towards our long-term goal of tissue engineered solutions to functional tendon-to-bone re-attachment, we tested the hypotheses that partially mineralized fibrous matrices can derive toughness from mobility of mineral along their fibers, and that in such cases toughness is maximized at levels of mineralization sufficiently low to allow substantial mobility. Nanofibrous electrospun poly(lactic-co-glycolic acid) (PLGA) scaffolds mineralized for prescribed times were fabricated as model systems to test these hypotheses. Tensile tests performed at varying angles relative to the dominant fiber direction confirmed that mineral cross-linked PLGA nanofibers without adhering to them. Peel tests revealed that fracture toughness increased with mineralization time up to a peak value, then subsequently decreased with increasing mineralization time back to the baseline toughness of unmineralized scaffolds. These experimental results were predicted by a theoretical model combining mineral growth kinetics with fracture energetics, suggesting that toughness increased with mineralization time until mineral mobility was attenuated by steric hindrance, then returned to baseline levels following the rigid percolation threshold. Results supported our hypotheses, and motivate further study of the roles of mobile mineral particles in toughening the tendon-to-bone attachment.
Effective surgical repair of interfaces between tendon and bone remains an unmet clinical need, in part due to a lack of understanding of how toughness is achieved in the healthy tissue. Using combined synthesis, experiment, and modeling approaches, the current work supported the hypothesis that toughening of a fibrous scaffold arises from brittle mineral particles that crosslink the fibers, but only if the particles are free to slide relative to the fibers. In the case of the tendon-to-bone interface, this suggests that partially mineralized tissue between tendon and bone, with mobile mineral but relatively low stiffness, may serve as a compliant, energy-absorbing barrier that guards against injury. These results suggest an opportunity for fabrication of tough and strong fibrous scaffolds for tissue engineering applications.
位于肌腱和骨骼之间的部分矿化纤维组织被认为比肌腱或骨骼更坚韧,可能作为两者之间顺应性、能量吸收性的保护屏障。这种组织在手术修复后(例如,肩袖肌腱与骨重新附着)不会再生,这可能是此类手术后效果不佳的一个因素。为了实现组织工程解决功能性肌腱与骨重新附着的长期目标,我们测试了以下假设:部分矿化纤维基质的韧性源于矿物质沿其纤维的移动性,并且在这种情况下,在矿化水平足够低以允许大量移动性时,韧性达到最大值。制备了在规定时间矿化的纳米纤维静电纺聚乳酸 - 乙醇酸共聚物(PLGA)支架作为模型系统来测试这些假设。相对于主要纤维方向以不同角度进行的拉伸试验证实,矿物质交联PLGA纳米纤维但不附着于它们。剥离试验表明,断裂韧性随着矿化时间增加到峰值,然后随着矿化时间的增加而下降回到未矿化支架的基线韧性。这些实验结果由一个将矿物质生长动力学与断裂能量学相结合的理论模型预测,表明韧性随着矿化时间增加,直到矿物质移动性因空间位阻而减弱,然后在刚性渗流阈值之后回到基线水平。结果支持了我们的假设,并促使进一步研究可移动矿物质颗粒在增强肌腱与骨附着方面的作用。
肌腱与骨界面的有效手术修复仍然是未满足的临床需求,部分原因是对健康组织中如何实现韧性缺乏了解。通过综合合成、实验和建模方法,当前工作支持了以下假设:纤维支架的增韧源于使纤维交联的脆性矿物质颗粒,但前提是颗粒能够相对于纤维自由滑动。对于肌腱与骨界面而言,这表明肌腱和骨之间部分矿化的组织,具有可移动的矿物质但相对较低的刚度,可能作为顺应性、能量吸收性屏障来防止损伤。这些结果为制造用于组织工程应用的坚韧且强壮的纤维支架提供了机会。