Functional tissue engineering for tendon repair: A multidisciplinary strategy using mesenchymal stem cells, bioscaffolds, and mechanical stimulation
- 3 August 2007
- journal article
- review article
- Published by Wiley in Journal of Orthopaedic Research
- Vol. 26 (1), 1-9
- https://doi.org/10.1002/jor.20456
Abstract
Over the past 8 years, our group has been continuously improving tendon repair using a functional tissue engineering (FTE) paradigm. This paradigm was motivated by inconsistent clinical results after tendon repair and reconstruction, and the modest biomechanical improvements we observed after repair of rabbit central patellar tendon defects using mesenchymal stem cell‐gel‐suture constructs. Although possessing a significantly higher stiffness and failure force than for natural healing, these first generation constructs were quite weak compared to normal tendon. Fundamental to the new FTE paradigm was the need to determine in vivo forces to which the repair tissue might be exposed. We first recorded these force patterns in two normal tendon models and then compared these peak forces to those for repairs of central defects in the rabbit patellar tendon model (PT). Replacing the suture with end‐posts in culture and lowering the mesenchymal stem cell (MSC) concentration of these constructs resulted in failure forces greater than peak in vivo forces that were measured for all the studied activities. Augmenting the gel with a type I collagen sponge further increased repair stiffness and maximum force, and resulted in the repair tangent stiffness matching normal stiffness up to peak in vivo forces. Mechanically stimulating these constructs in bioreactors further enhanced repair biomechanics compared to normal. We are now optimizing components of the mechanical signal that is delivered in culture to further improve construct and repair outcome. Our contributions in the area of tendon functional tissue engineering have the potential to create functional load‐bearing repairs that will revolutionize surgical reconstruction after tendon and ligament injury. © 2007 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 26:1–9, 2008Keywords
This publication has 24 references indexed in Scilit:
- Effects of Mechanical Stimulation on the Biomechanics and Histology of Stem Cell–Collagen Sponge Constructs for Rabbit Patellar Tendon RepairTissue Engineering, 2006
- The Effect of Autologous Mesenchymal Stem Cells on the Biomechanics and Histology of Gel-Collagen Sponge Constructs Used for Rabbit Patellar Tendon RepairTissue Engineering, 2006
- Injuries of the WristOrthopaedic Nursing, 2005
- Tendon healing in vitro: Modification of tenocytes with exogenous vascular endothelial growth factor gene increases expression of transforming growth factor β but minimally affects expression of collagen genesThe Journal of Hand Surgery, 2005
- Effects of Cell-to-Collagen Ratio in Mesenchymal Stem Cell-Seeded Implants on Tendon Repair Biomechanics and HistologyTissue Engineering, 2005
- Mesenchymal stem cells used for rabbit tendon repair can form ectopic bone and express alkaline phosphatase activity in constructsJournal of Orthopaedic Research, 2004
- Functional Efficacy of Tendon Repair ProcessesAnnual Review of Biomedical Engineering, 2004
- Cell differentiation by mechanical stressThe FASEB Journal, 2001
- Use of mesenchymal stem cells in a collagen matrix for achilles tendon repairJournal of Orthopaedic Research, 1998
- The use of an implantable force transducer to measure patellar tendon forces in goatsJournal of Biomechanics, 1996