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Three-Dimensional Bio-Printed Scaffold Sleeves With Mesenchymal Stem Cells for Enhancement of Tendon-to-Bone Healing in Anterior Cruciate Ligament Reconstruction Using Soft-Tissue Tendon Graft

Authors
Park, Sin HyungChoi, Yeong-JinMoon, Sang WonLee, Byung HoonShim, Jin-HyungCho, Dong-WooWang, Joon Ho
Issue Date
Jan-2018
Publisher
W. B. Saunders Co., Ltd.
Keywords
Three-Dimensional Bio-Printed Scaffold Sleeves
Citation
Arthroscopy - Journal of Arthroscopic and Related Surgery, v.34, no.1, pp 166 - 179
Pages
14
Journal Title
Arthroscopy - Journal of Arthroscopic and Related Surgery
Volume
34
Number
1
Start Page
166
End Page
179
URI
https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/6340
DOI
10.1016/j.arthro.2017.04.016
ISSN
0749-8063
1526-3231
Abstract
Purpose: To investigate the efficacy of the insertion of 3-dimensional (3D) bio-printed scaffold sleeves seeded with mesenchymal stem cells (MSCs) to enhance osteointegration between the tendon and tunnel bone in anterior cruciate ligament (ACL) reconstruction in a rabbit model. Methods: Scaffold sleeves were fabricated by 3D bio-printing. Before ACL reconstruction, MSCs were seeded into the scaffold sleeves. ACL reconstruction with hamstring tendon was performed on both legs of 15 adult rabbits (aged 12 weeks). We implanted 15 bone tunnels with scaffold sleeves with MSCs and implanted another 15 bone tunnels with scaffold sleeves without MSCs before passing the graft. The specimens were harvested at 4, 8, and 12 weeks. H&E staining, immunohistochemical staining of type II collagen, and microecomputed tomography of the tunnel cross-sectional area were evaluated. Histologic assessment was conducted with a histologic scoring system. Results: In the histologic assessment, a smooth bone-to-tendon transition through broad fibrocartilage formation was identified in the treatment group, and the interface zone showed abundant type II collagen production on immunohistochemical staining. Bone-tendon healing histologic scores were significantly higher in the treatment group than in the control group at all time points. Microecomputed tomography at 12 weeks showed smaller tibial (control, 9.4 +/- 0.9 mm(2); treatment, 5.8 +/- 2.9 mm(2); P = .044) and femoral (control, 9.6 +/- 2.9 mm(2); treatment, 6.0 +/- 1.0 mm(2); P = .03) bone-tunnel areas in the treated group than in the control group. Conclusions: The 3D bio-printed scaffold sleeve with MSCs exhibited excellent results in osteointegration enhancement between the tendon and tunnel bone in ACL reconstruction in a rabbit model.
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