Potential of Graphene–Polymer Composites for Ligament and Tendon Repair: A Review

Abstract

Tendon/ligament injuries are debilitating conditions that affect the life quality of a great percentage of the adult population. Several challenges still have to be addressed regarding the repair of these tissues, as current treatments show limited success. The use of biocompatible and biodegradable polymeric scaffolds potentially helps accomplish a complete and long‐term functional repair but, unfortunately, these materials lack adequate mechanical properties to be used in such demanding applications. Graphene is a subject of interest for tissue‐repair applications due to its electrical conductivity and mechanical properties. If incorporated adequately, it may significantly improve the physical properties of the composite, even at small loadings. Furthermore, graphene presents a biocompatible surface that may enhance cell adhesion, proliferation and differentiation and demonstrates promising outcomes in several in vitro and in vivo biological applications. Therefore, herein, the potential of graphene materials for the reinforcement of biodegradable polymers of interest for tendon/ligament repair is explored. The effect of graphene on relevant features such as mechanical properties, biodegradability, and biocompatibility is revised, to understand the feasibility of these composites to fulfill the requirements associated with these tissues and conclude how their applicability is extended to this field.

Scaffold-Mediated Immunoengineering as Innovative Strategy for Tendon Regeneration

“…Furthermore, it has been determined that a sub-cytotoxic dose of pristine graphene modulates macrophage morphology by modifying actin assembly and reducing their ability to adhere to the ECM [ 108 ]. Graphene oxide (GO), which represents the result of graphene oxidation to increase hydrophilicity and preparation of composites [ 109 ], has been shown to possess immunomodulatory properties, making them involved in the modulation of immune cells, neutrophils, macrophages, dendritic cells [ 110 ]. For example, GO sheets induce macrophage polarization to the M1 phenotype, enhancing the pro-inflammatory response [ 111 ].…”

“…It was only during this decade that GO was first incorporated into polymeric electrospun nanofibers [ 118 ]. Currently, several research teams are addressing their study on the evaluation of composites of this material with electrospun polymer scaffolds for tendon repair, for review [ 109 ]. Further studies are needed to investigate the employment other immunomodulatory biomaterials in the electrospinning technique.…”

Antimicrobial Synthetic and Natural Polymeric Nanofibers as Wound Dressing: A Review

“…Wound dressings made of nanofiber polymers with antibacterial effects and skin regeneration capabilities are good choices for preventing wound infection and speeding wound healing. [183][184][185][186][187][188][189][190][191][192] Antimicrobial agents have been applied to nanofibers to boost their antimicrobial activity. Antimicrobial substances, both inorganic and organic, have been used to achieve this aim.…”

Carbon‐Based Materials for Articular Tissue Engineering: From Innovative Scaffolding Materials toward Engineered Living Carbon

“…These graphene-based nanomaterials are also being explored as reinforcements in polymer-carbon nanocomposites for ligament and tendon repair. [102] Toward achieving truly 3D graphene-based scaffolds, apart from the possibility of resorting to graphene-based nanocomposites, the possibility of synthesizing graphene foams has been researched in connection with cardiac [103] and neural [104] tissue engineering applications. In both areas, enhanced cell proliferation and superior gene expression for the desired applications have been reported for the 3D graphene foams, when compared to conventional 2D graphene.…”