College of Engineering and Applied Sciences, University of Cincinnati, Cincinnati, Ohio, USA.
J Tissue Eng Regen Med. 2022 Dec;16(12):1091-1108. doi: 10.1002/term.3360. Epub 2022 Nov 17.
This review paper is motivated by a Back-to-Basics presentation given by the author at the 2022 Orthopaedic Research Society meeting in Tampa, Florida. I was tasked with providing a brief history of research leading up to the introduction of functional tissue engineering (FTE) for tendon and ligament repair. Beginning in the 1970s, this timeline focused on two common orthopedic soft tissue problems, anterior cruciate ligament ruptures in the knee and supraspinatus tendon injuries in the shoulder. Historic changes in the field over the next 5 decades revealed a transformation from a focus more on mechanics (called "bioMECHANICS") on a larger (tissue) scale to a more recent focus on biology (called "mechanoBIOLOGY") on a smaller (cellular and molecular) scale. Early studies by surgeons and engineers revealed the importance of testing conditions for ligaments and tendons (e.g., high strain rates while avoiding subject disuse and immobility) and the need to measure in vivo forces in these tissues. But any true tissue engineering and regeneration in these early decades was limited more to the use of auto-, allo- and xenografts than actual generation of stimulated cell-scaffold constructs in culture. It was only after the discovery of tissue engineering in 1988 and the recognition of frequent rotator cuff injuries in the early 1990s, that biologists joined surgeons and engineers to discover mechanical and biological testing criteria for FTE. This review emphasizes the need for broader and more inclusive collaborations by surgeons, biologists and engineers in the short term with involvement of those in biomaterials, manufacturing, and regulation of new products in the longer term.
这篇综述论文的灵感来自于作者在 2022 年佛罗里达州坦帕市骨科研究学会会议上的一次基础回顾演讲。我的任务是提供一段历史背景，介绍在引入功能组织工程（FTE）用于肌腱和韧带修复之前的研究进展。从 20 世纪 70 年代开始，这一时间线主要关注两个常见的骨科软组织问题，膝关节前交叉韧带断裂和肩部肩袖肌腱损伤。在接下来的 50 年里，该领域的历史变化揭示了一个从更关注力学（称为“生物力学”）的较大（组织）尺度向更关注生物学（称为“力学生物学”）的较小（细胞和分子）尺度的转变。外科医生和工程师的早期研究揭示了测试韧带和肌腱的条件的重要性（例如，高应变率，同时避免受试者失用和固定不动），以及需要测量这些组织中的体内力。但是，在这些早期几十年中，任何真正的组织工程和再生都更多地局限于使用自体、同种异体和异种移植物，而不是在培养物中实际生成受刺激的细胞-支架构建体。直到 1988 年发现组织工程学和 20 世纪 90 年代早期认识到频繁的肩袖损伤之后，生物学家才与外科医生和工程师合作，发现 FTE 的机械和生物学测试标准。这篇综述强调了外科医生、生物学家和工程师在短期内需要更广泛和更具包容性的合作，长期而言需要那些参与生物材料、制造和新产品监管的人参与进来。
