School of Medicine, Griffith University, Gold Coast, Queensland, Australia.
Department of Orthopaedic Surgery, Gold Coast University Hospital, Gold Coast, Queensland, Australia.
J Orthop Res. 2021 Aug;39(8):1811-1824. doi: 10.1002/jor.24785. Epub 2020 Jul 7.
Scapholunate interosseous ligament tears are a common wrist injury in young and active patients that can lead to suboptimal outcomes after repair. This research aims to assess a multiphasic scaffold using 3D-printing for reconstruction of the dorsal scapholunate interosseous ligament. The scaffold was surgically implanted in vivo in the position of the native rabbit medial collateral ligament. Two branches of treatment were implemented in the study. In the first group, the rabbits (n = 8) had the knee joint fixed in flexion for 4 weeks using 1.4 mm K-wires prior to sample harvesting. The second group (n = 8) had the rabbit knee joint immobilized for 4 weeks prior to K-wire removal and mobilization for an additional 4 weeks prior to sample harvesting. Overall, samples were harvested at 4 weeks post-surgery (immobilized group) and eight weeks post-surgery (mobilized group). Mechanical tensile testing (n = 5/group) and histology (n = 3/group) of the constructs were conducted. Tissue integration and maturation were observed resulting in increased mechanical strength of the operated joint at 8 weeks (P < .05). Bone and ligament tissues were regenerated in their respective compartments with structural and mechanical properties approaching those reported for the human dorsal SLIL ligament. Clinical Significance: This proof of concept study has demonstrated that the synthetic multiphasic scaffold was capable of regenerating both bone and ligament while also withstanding the physiological load once implanted in the rabbit knee. The artificial scaffold may provide an alternative to current techniques for reconstruction of scapholunate instability or other ligament injuries in the hand and wrist.
舟月骨间韧带撕裂是年轻且活跃患者常见的腕部损伤,如果修复不当,可能会导致预后不佳。本研究旨在评估一种使用 3D 打印技术构建的多相支架,用于重建背侧舟月骨间韧带。该支架被手术植入到兔内侧副韧带的自然位置。研究中实施了两种治疗分支。在第一组中,兔子(n=8)在膝关节用 1.4mm K 线固定在屈曲位置 4 周,然后进行样本采集。第二组(n=8)在膝关节用 K 线固定 4 周,然后移除 K 线并在移动 4 周后进行样本采集。总体而言,术后 4 周(固定组)和 8 周(移动组)采集样本。对构建体进行了力学拉伸测试(n=5/组)和组织学(n=3/组)分析。观察到组织整合和成熟,导致术后 8 周手术关节的机械强度增加(P<.05)。骨和韧带组织在各自的腔室内再生,其结构和机械性能接近报道的人背侧 SLIL 韧带。临床意义:本概念验证研究表明,合成多相支架能够在植入兔膝关节后,既能再生骨又能再生韧带,同时还能承受生理负荷。人工支架可能为治疗手部和腕部舟月骨不稳定或其他韧带损伤提供一种替代当前技术的方法。