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A model scaffold for anterior cruciate ligament tissue engineering

Abstract

Ligament/tendon disorders and injuries are among the most common health problem influencing the adult and sports population. Anterior cruciate ligament (ACL), is one of the ligament most injured in the knee, and the soft-to-hard tissue integration shows high rupture rates. To overcome problems related to therapies currently used in medical practice, tissue engineering (TE) has recently emerged as an alternative strategy. TE is a field that applies principles of biology, engineering and medicine toward the development of biological tissue substitutes to restore, repair or improve damaged tissues. Ligament/tendon TE focuses on the combination of specific cell types with a biodegradable scaffold, resembling the original extracellular matrix (ECM) of the damaged tissue, to restore its functionalities. Once implanted, the scaffold has gradually to degrade, while the tissue is regenerating. The scaffold should be able to promote cell adhesion and differentiation, especially when growth factor and/or bioreactor are combined to trigger cell response. Different scaffold materials have been successfully studied, but among them, silk fibroin has emerged as promising for TE applications. It is a natural protein forming the structural core of silk filaments, that shows biocompatibility, mechanical properties and biodegradation rate suitable for ligament/tendon TE applications.

n this work, it has been demonstrated the versatility of silk fibroin in tendon/ligament TE. The fabrication of a scaffold using a porous gradient combined with signalling molecules (such as growth factors) conjugation, led to stem cell differentiation.

Moreover, the use of silk fibroin yarn, resulted as an improvement of the mechanical properties in a multicomponent scaffold. In addition, the stimulation of a homemade perfusion bioreactor supplied nutrients and improved cell migration. These achievements indicated that silk fibroin can be a powerful material for the realization of a model scaffold for further applications in tendon/ligament tissue engineering.