Objective To solve the fixation problem between ligament grafts and host bones in ligament reconstruction surgery by using ligament-bone composite scaffolds to repair the ligaments, to explore the fabrication method for ligament-bone composite scaffolds based on three-dimensional (3-D) printing technique, and to investigate their mechanical and biological properties in animal experiments.
Methods The model of bone scaffolds was designed using CAD software, and the corresponding negative mould was created by boolean operation. 3-D printing techinique was employed to fabricate resin mold. Ceramic bone scaffolds were obtained by casting the ceramic slurry in the resin mould and sintering the dried ceramics-resin composites. Ligament scaffolds were obtained by weaving degummed silk fibers, and then assembled with bone scaffolds and bone anchors. The resultant ligament-bone composite scaffolds were implanted into 10 porcine left anterior cruciate ligament rupture models at the age of 4 months. Mechanical testing and histological examination were performed at 3 months postoperatively, and natural anterior cruciate ligaments of the right sides served as control.
Results Biomechanical testing showed that the natural anterior cruciate ligament of control group can withstand maximum tensile force of (1 384±181) N and dynamic creep of (0.74±0.21) mm, while the regenerated ligament-bone scaffolds of experimental group can withstand maximum tensile force of (370±103) N and dynamic creep of (1.48±0.49) mm, showing significant differences (t=11.617,P=0.000; t=-2.991,P=0.020). In experimental group, histological examination showed that new bone formed in bone scaffolds. A hierarchical transition structure regenerated between ligament-bone scaffolds and the host bones, which was similar to the structural organizations of natural ligament-bone interface.
Conclusion Ligament-bone composite scaffolds based on 3-D printing technique facilitates the regeneration of biomimetic ligament-bone interface. It is expected to achieve physical fixation between ligament grafts and host bone.
Citation：
ZHANGWenyou, HEJiankang, LIXiang, LIUYaxiong, BIANWeiguo, LIDichen, JINZhongmin. FABRICATION AND IN VIVO IMPLANTATION OF LIGAMENT-BONE COMPOSITE SCAFFOLDS BASED ON THREE-DIMENSIONAL PRINTING TECHNIQUE. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(3): 314-317. doi: 10.7507/1002-1892.20140071
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- 1. Spalazzi JP, Doty SB, Moffat KL, et al. Development of controlled matrix heterogeneity on a triphasic scaffold for orthopedic interface tissue engineering. Tissue Eng, 2006, 12(12):3497-3508.
- 2. Guarino V, Causa F, Ambrosio L. Bioactive scaffolds for bone and ligament tissue. Expert Rev Med Devices, 2007, 4(3):405-418.
- 3. Liu H, Fan H, Toh SL, et al. A comparison of rabbit mesenchymal stem cells and anterior cruciate ligament fibroblasts responses on combined silk scaffolds. Biomaterials, 2008, 29(10):1443-1453.
- 4. Fan H, Liu H, Toh SL, et al. Anterior cruciate ligament regeneration using mesenchymal stem cells and silk scaffold in large animal model. Biomaterials, 2009, 30(28):4967-4977.
- 5. Sahoo S, Toh SL, Goh JC. A bFGF-releasing silk/PLGA-based biohybrid scaffold for ligament/tendon tissue engineering using mesenchymal progenitor cells. Biomaterials, 2010, 31(11):2990-2998.
- 6. Shen WL, Chen X, Chen J, et al. The effect of incorporation of exogenous stromal cell-derived factor-1 alpha within a knitted silk-collagen sponge scaffold on tendon regeneration. Biomaterials, 2010, 31(28):7239-7249.
- 7. Li X, Bian W, Li D, et al. Fabrication of porous beta-tricalcium phosphate with microchannel and customized geometry based on gel-casting and rapid prototyping. Proc Inst Mech Eng H, 2011, 225(3):315-323.
- 8. Li X, Snedeker JG. Wired silk architectures provide a biomimetic ACL tissue engineering scaffold. J Mech Behav Biomed Mater, 2013, 22:30-40.
- 9. Lee J, Choi WI, Tae G, et al. Enhanced regeneration of the ligament-bone interface using a poly (L-lactide-co-epsilon-caprolactone) scaffold with local delivery of cells/BMP-2 using a heparin-based hydrogel. Acta Biomater, 2011, 7(1):244-257.
- 10. He P, Sahoo S, Ng KS, et al. Enhanced osteoinductivity and osteoconductivity through hydroxyapatite coating of silk-based tissue-engineered ligament scaffold. J Biomed Mater Res A, 2013, 101(2):555-566.
