Ligament Replacement with an Absorbable Copolymer Carbon Fiber Scaffold-Early Clinical Experience

Weiss, Andrew B.; Blazina, Martin E.; Goldstein, Andrew R.; Alexander, Harold

doi:10.1097/00003086-198506000-00012

Cited by 56 publications

(23 citation statements)

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“…The mechanical properties and biocompatibility of the carbon-polylactic acid-polycapralactone (carbon copolymer) composite ligament prosthesis make it suitable for use as a scaffold material for the repair and reconstruction of human ligaments and tendons. 10 In the present study, the early (6 weeks) clinical experience with the knee collateral and cruciate ligaments demonstrated well-vascularized reconstructions with collagenous tissue ingrowth into the carbon copolymer implants. However, long-term studies indicate that the carbon fiber slowly breaks up at the site of implantation and later begins to appear in the regional lymph nodes.…”

supporting

confidence: 57%

“…Several groups have reported the potential construction of an ACL scaffold using a carbon copolymer, collagen, silk, and biodegradable polymers, such as polyglycolic acid (PGA) and polylactic acid (PLA). [9][10][11][12][13][14][15] The use of composite ACL prostheses, the union of a collagen inductor and a synthetic fiber (Dacron 1 ), was investigated as a possible means of ACL reconstruction. Composite ACL prostheses were implanted in 10 sheep models for 6 months.…”

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confidence: 99%

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Increase in cell migration and angiogenesis in a composite silk scaffold for tissue‐engineered ligaments

Seo

Yoon

Song

et al. 2009

Journal Orthopaedic Research

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The purpose of this study was to evaluate the biocompatibility of silk and collagen-hyaluronan (HA) in vitro by assessing anterior cruciate ligament (ACL) cell and T-lymphocyte cultures on scaffolds. The use of composite scaffolds as artificial ligaments in ACL reconstruction and their effects on angiogenesis were evaluated in vivo. The silk scaffold was knitted by hand and dry coated with collagen-HA, whereas the composite silk scaffold was made by covering a silk scaffold with a lyophilized collagen-HA substrate. The initial attachment and proliferation of human ACL cells on the composite silk scaffold was superior to the attachment and proliferation observed on the silk scaffold. The immune response was higher in both scaffolds after 72 h ( p < 0.05) compared with the control culture condition without scaffolding, as assessed by T-lymphocyte cultures in vitro. There was no significant difference in the immune response in vitro between the silk and composite silk scaffolds. Silk and composite silk scaffolds were implanted as artificial ligaments in ACLs removed from the knees of dogs, and they were harvested 6 weeks after implantation. On gross examination, the onset of an inflammatory tissue reaction, such as synovitis, was seen in both the silk scaffold and the composite silk scaffold groups. An histological evaluation of the artificial ligament implants revealed the presence of monocytes in the silk composite scaffold and the absence of giant cells in all cases. MT staining in the composite silk scaffold-grafted group showed granulation tissue consisting of fibroblasts, lymphocytes, monocytes, and collagen fibers. In addition, CD31 staining revealed the formation of new blood vessels. On the other hand, no reparative tissues, such as blood vessels, collagen, and cells, were observed in the silk scaffold-grafted group. These results suggest that the lyophilized collagen-HA substrate is biocompatible in vitro and enhances new blood vessel and cell migration in vivo. ß

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supporting

confidence: 57%

mentioning

confidence: 99%

Increase in cell migration and angiogenesis in a composite silk scaffold for tissue‐engineered ligaments

Seo

Yoon

Song

et al. 2009

Journal Orthopaedic Research

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“…21 It is hypothesized that the repaired ACL fails to heal because of a combination of factors including lack of formation of a blood clot, lack of vascular supply, deficits in intrinsic cell migration, impaired growth factor availability, and environmental effects of the synovial fluid on cell morphology. [22][23][24][25][26][27][28][29][30][31][32][33][34] These problems have led to research into the biology of the ACL's response to injury and healing. Lo et al 35 reported that ACL fibroblasts from torn ligaments had the ability to up-regulate ligament specific markers including collagen types 1 and III and tissue inhibitor metalloproteinase-1 (an inhibitor to collagenase) for up to 1 year post-trauma.…”

Section: Potential For Acl Repairmentioning

confidence: 99%

Future trends in ACL rupture management

Gopinathan

2017

Journal of Orthopaedics

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“…One hypothesis (12,15,21) holds that, in the presence of a tensile force, immature fibrous tissue so formed will gradually mature with its fibers oriented functionally. However, this is disputed by reports (3,4,18) that the induced tissue is characterized by a chronic foreign-body reaction and by disorderly collagen fibers.…”

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confidence: 99%

Histological and biochemical analysis of the fibrous tissue induced by implantation of synthetic ligament (Dacron): An experimental study in a rat model

Irie

Kurosawa

Oda

1992

Journal Orthopaedic Research

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We conducted a comparative study to evaluate the quality and true nature of the fibrous tissue formed around synthetic grafts when used in ligament replacement. In one group of Lewis rats, a patellar ligament was replaced with a Dacron prosthesis; the comparison group received a tail tendon isograft. Two-, 4-, 8-, 12-, and 24-week comparisons showed histological and biochemical changes in the Dacron group alone that were consistent with foreign-body reaction. Specifically, the Dacron group showed infiltration by large numbers of macrophages and foreign-body, multinucleated giant cells. In addition, the capsule of fibrous tissue that developed around the Dacron ligaments was characterized by lower collagen solubility, a higher content of noncollagenous protein, and a higher proportion of type III collagen than that comprising the isografted tendons. The results of this study call into question the suitability of synthetics for ligament replacement.

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Ligament Replacement with an Absorbable Copolymer Carbon Fiber Scaffold-Early Clinical Experience

Cited by 56 publications

References 0 publications

Increase in cell migration and angiogenesis in a composite silk scaffold for tissue‐engineered ligaments

Increase in cell migration and angiogenesis in a composite silk scaffold for tissue‐engineered ligaments

Future trends in ACL rupture management

Histological and biochemical analysis of the fibrous tissue induced by implantation of synthetic ligament (Dacron): An experimental study in a rat model

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