title: Tissue-engineered collateral ligament composite allografts for scapholunate ligament reconstruction: an experimental study.
abstract: OBJECTIVE
  In patients with chronic scapholunate (SL) dissociation or dynamic instability, ligament repair is often not possible, and surgical reconstruction is indicated. The ideal graft ligament would recreate both anatomical and biomechanical properties of the dorsal scapholunate ligament (dorsal SLIL). The finger proximal interphalangeal joint (PIP joint) collateral ligament could possibly be a substitute ligament.
  
  
  METHODS
  We harvested human PIP joint collateral ligaments and SL ligaments from 15 cadaveric limbs. We recorded ligament length, width, and thickness, and measured the biomechanical properties (ultimate load, stiffness, and displacement to failure) of native dorsal SLIL, untreated collateral ligaments, decellularized collateral ligaments, and SL repairs with bone-collateral ligament-bone composite collateral ligament grafts. As proof of concept, we then reseeded decellularized bone-collateral ligament-bone composite grafts with green fluorescent protein-labeled adipo-derived mesenchymal stem cells and evaluated them histologically.
  
  
  RESULTS
  There was no difference in ultimate load, stiffness, and displacement to failure among native dorsal SLIL, untreated and decellularized collateral ligaments, and SL repairs with tissue-engineered collateral ligament grafts. With pair-matched untreated and decellularized scaffolds, there was no difference in ultimate load or stiffness. However, decellularized ligaments revealed lower displacement to failure compared with untreated ligaments. There was no difference in displacement between decellularized ligaments and native dorsal SLIL. We successfully decellularized grafts with recently described techniques, and they could be similarly reseeded.
  
  
  CONCLUSIONS
  Proximal interphalangeal joint collateral ligament-based bone-collateral ligament-bone composite allografts had biomechanical properties similar to those of native dorsal SLIL. Decellularization did not adversely affect material properties.
  
  
  CONCLUSIONS
  These tissue-engineered grafts may offer surgeons another option for reconstruction of chronic SL instability.
authors: Division of Plastic and Reconstructive Surgery, Stanford University Medical Center and Section of Plastic Surgery, Stanford, CA, USA.
authors: Ryan
authors: R
authors: Endress
authors: Colin Y L
authors: CY
authors: Woon
authors: Simon J
authors: SJ
authors: Farnebo
authors: Anthony
authors: A
authors: Behn
authors: Joel
authors: J
authors: Bronstein
authors: Hung
authors: H
authors: Pham
authors: Xinrui
authors: X
authors: Yan
authors: Sanjiv S
authors: SS
authors: Gambhir
authors: James
authors: J
authors: Chang
mesh_terms: D000704:Analysis of Variance; D001696:Biomechanical Phenomena; D002102:Cadaver; D017885:Collateral Ligaments / Q000637:transplantation*; D006801:Humans; D020007:Implants, Experimental; D007593:Joint Instability / Q000601:surgery*; D008023:Ligaments, Articular / Q000601:surgery*; D012667:Lunate Bone / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D021361:Scaphoid Bone / Q000601:surgery*; D013314:Stress, Mechanical; D023822:Tissue Engineering / Q000379:methods*; D014184:Transplantation, Homologous