Fresh Versus Frozen Engineered Bone-Ligament-Bone Grafts for Sheep Anterior Cruciate Ligament Repair
Fresh Versus Frozen Engineered Bone-Ligament-Bone Grafts for Sheep Anterior Cruciate Ligament Repair
复制标题
DOI：
10.1089/ten.tec.2014.0542
复制
发表时间：
2015-06-01
影响因子：
3
通讯作者：
Larkin, Lisa M.
中科院分区：
文献类型：
--
作者：
Mahalingam, Vasudevan D.;Behbahani-Nejad, Nilofar;Larkin, Lisa M.
前交叉韧带 (ACL) 损伤患者通常需要手术干预来恢复膝关节不稳定性。 ACL 重建最常用的移植物是自体肌腱或同种异体肌腱。然而，目前的这些选择已显示出需要修改的失败率以及长期持续的不稳定。与天然 ACL 组织相比，当前肌腱移植物的生物力学特性不匹配被认为是导致这些不良结果和早发骨关节炎的潜在风险的原因。作为这些问题的可能解决方案，我们的实验室制造了组织工程韧带结构，在植入 6 个月后，其表现出与天然 ACL 组织相似的结构和功能特性。此外，这些组织工程移植物实现了超过髌腱移植物的血管和神经发育。然而，我们的组织工程移植物的实用性受到生产构建体所需的劳动密集型方法的限制，并且需要直接使用来自细胞培养系统的新鲜构建体。理想情况下，这些结构将被制造并储存起来直到需要为止。因此，在这项研究中，我们研究了在用于 ACL 重建之前冷冻组织工程结构作为保存方法的功效。我们假设冷冻结构与我们的新鲜模型相比具有相似的组织学和生物力学结果。我们的结果表明，作为 ACL 替代移植物植入后 6 个月，我们的组织工程新鲜移植物和冷冻移植物都表现出相似的机械和组织学结果，表明冷冻是在 ACL 重建之前保存和储存移植物的合适方法。使用冷冻结构的能力显着增加了我们的移植技术的多功能性，扩大了我们的移植物的临床用途。
Surgical intervention is often required to restore knee instability in patients with anterior cruciate ligament (ACL) injury. The most commonly used grafts for ACL reconstruction are tendon autografts or allografts. These current options, however, have shown failure rates requiring revision and continued instability in the long term. The mismatched biomechanical properties of the current tendon grafts compared with native ACL tissue are thought to contribute to these poor outcomes and potential risk of early onset osteoarthritis. As a possible solution to these issues, our laboratory has fabricated tissue-engineered ligament constructs that exhibit structural and functional properties similar to those of native ACL tissue after 6 months implantation. In addition, these tissue-engineered grafts achieve vascular and neural development that exceeds those of patellar tendon grafts. However, the utility of our tissue-engineered grafts is limited by the labor-intensive method required to produce the constructs and the need to use the constructs fresh, directly from the cell culturing system. Ideally, these constructs would be fabricated and stored until needed. Thus, in this study, we investigated the efficacy of freezing our tissue-engineered constructs as a method of preservation before use for ACL reconstruction. We hypothesized that frozen constructs would have similar histological and biomechanical outcomes compared with our fresh model. Our results showed that 6 months postimplantation as an ACL replacement graft, both our tissue-engineered fresh and frozen grafts demonstrated similar mechanical and histological outcomes, indicating that freezing is a suitable method for preserving and storing our graft before ACL reconstruction. The ability to use frozen constructs significantly increases the versatility of our graft technology expanding the clinical utility of our graft.