[Fabrication and in vivo implantation of ligament-bone composite scaffolds based on three-dimensional printing technique].
OBJECTIVE
To solve the fixation problem between ligament grafts and host bones in ligament reconstruction surgery by using ligament-bone composite scaffolds to repair the ligaments, to explore the fabrication method for ligament-bone composite scaffolds based on three-dimensional (3-D) printing technique, and to investigate their mechanical and biological properties in animal experiments.


METHODS
The model of bone scaffolds was designed using CAD software, and the corresponding negative mould was created by boolean operation. 3-D printing techinique was employed to fabricate resin mold. Ceramic bone scaffolds were obtained by casting the ceramic slurry in the resin mould and sintering the dried ceramics-resin composites. Ligament scaffolds were obtained by weaving degummed silk fibers, and then assembled with bone scaffolds and bone anchors. The resultant ligament-bone composite scaffolds were implanted into 10 porcine left anterior cruciate ligament rupture models at the age of 4 months. Mechanical testing and histological examination were performed at 3 months postoperatively, and natural anterior cruciate ligaments of the right sides served as control.


RESULTS
Biomechanical testing showed that the natural anterior cruciate ligament of control group can withstand maximum tensile force of (1 384 +/- 181) N and dynamic creep of (0.74 +/- 0.21) mm, while the regenerated ligament-bone scaffolds of experimental group can withstand maximum tensile force of (370 +/- 103) N and dynamic creep of (1.48 +/- 0.49) mm, showing significant differences (t = 11.617, P = 0.000; t = 2.991, P = 0.020). In experimental group, histological examination showed that new bone formed in bone scaffolds. A hierarchical transition structure regenerated between ligament-bone scaffolds and the host bones, which was similar to the structural organizations of natural ligament-bone interface.


CONCLUSIONS
Ligament-bone composite scaffolds based on 3-D printing technique facilitates the regeneration of biomimetic ligament-bone interface. It is expected to achieve physical fixation between ligament grafts and host bone.
Wenyou
W
Zhang
Jiankang
J
He
Xiang
X
Li
Yaxiong
Y
Liu
Weiguo
W
Bian
Dichen
D
Li
Zhongmin
Z
Jin
D000818:Animals; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D001672:Biocompatible Materials / Q000737:chemistry; D001696:Biomechanical Phenomena; D002130:Calcium Phosphates / Q000737:chemistry; D017076:Computer-Aided Design; D007719:Knee Joint / Q000601:surgery; D008297:Male; D010012:Osteogenesis; D011327:Printing / Q000379:methods*; D019736:Prostheses and Implants; D047011:Silk / Q000737:chemistry; D013552:Swine; D013718:Tensile Strength; D023822:Tissue Engineering / Q000379:methods; D054457:Tissue Scaffolds / Q000737:chemistry*
D001672:Biocompatible Materials; D002130:Calcium Phosphates; D047011:Silk; C485817:beta-tricalcium phosphate