title: Long-term effects of knitted silk-collagen sponge scaffold on anterior cruciate ligament reconstruction and osteoarthritis prevention.
abstract: Anterior cruciate ligament (ACL) is difficult to heal after injury due to the dynamic fluid environment of joint. Previously, we have achieved satisfactory regeneration of subcutaneous tendon/ligament with knitted silk-collagen sponge scaffold due to its specific "internal-space-preservation" property. This study aims to investigate the long-term effects of knitted silk-collagen sponge scaffold on ACL regeneration and osteoarthritis prevention. The knitted silk-collagen sponge scaffold was fabricated and implanted into a rabbit ACL injury model. The knitted silk-collagen sponge scaffold was found to enhance migration and adhesion of spindle-shaped cells into the scaffold at 2 months post-surgery. After 6 months, ACL treated with the knitted silk-collagen sponge scaffold exhibited increased expression of ligament genes and better microstructural morphology. After 18 months, the knitted silk-collagen sponge scaffold-treated group had more mature ligament structure and direct ligament-to-bone healing. Implanted knitted silk-collagen sponge scaffolds degraded much more slowly compared to subcutaneous implantation. Furthermore, the knitted silk-collagen sponge scaffold effectively protected joint surface cartilage and preserved joint space for up to 18 months post-surgery. These findings thus demonstrated that the knitted silk-collagen sponge scaffold can regenerate functional ACL and prevent osteoarthritis in the long-term, suggesting its clinical use as a functional bioscaffold for ACL reconstruction.
authors: Department of Sports Medicine, School of Medicine, Zhejiang University, Zhejiang 310000, China; Department of Orthopedic Surgery, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang 310009, China; Zhejiang Key Laboratory for Tissue Engineering and Repair Technology, School of Medicine, Zhejiang University, Zhejiang 310009, China.
authors: Weiliang
authors: W
authors: Shen
authors: Department of Sports Medicine, School of Medicine, Zhejiang University, Zhejiang 310000, China; Center for Stem Cell and Tissue Engineering, School of Medicine, Zhejiang University, Zhejiang 310000, China.
authors: Xiao
authors: X
authors: Chen
authors: Department of Orthopedic Surgery, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang 310009, China.
authors: Yejun
authors: Y
authors: Hu
authors: Department of Sports Medicine, School of Medicine, Zhejiang University, Zhejiang 310000, China; Center for Stem Cell and Tissue Engineering, School of Medicine, Zhejiang University, Zhejiang 310000, China.
authors: Zi
authors: Z
authors: Yin
authors: Department of Orthopedic Surgery, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang 310009, China.
authors: Ting
authors: T
authors: Zhu
authors: Department of Sports Medicine, School of Medicine, Zhejiang University, Zhejiang 310000, China; Center for Stem Cell and Tissue Engineering, School of Medicine, Zhejiang University, Zhejiang 310000, China.
authors: Jiajie
authors: J
authors: Hu
authors: Department of Sports Medicine, School of Medicine, Zhejiang University, Zhejiang 310000, China; Center for Stem Cell and Tissue Engineering, School of Medicine, Zhejiang University, Zhejiang 310000, China.
authors: Jialin
authors: J
authors: Chen
authors: Department of Orthopedic Surgery, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang 310009, China.
authors: Zefeng
authors: Z
authors: Zheng
authors: Department of Sports Medicine, School of Medicine, Zhejiang University, Zhejiang 310000, China; Center for Stem Cell and Tissue Engineering, School of Medicine, Zhejiang University, Zhejiang 310000, China.
authors: Wei
authors: W
authors: Zhang
authors: Department of Orthopedic Surgery, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang 310009, China.
authors: Jisheng
authors: J
authors: Ran
authors: Department of Biosystems Science & Engineering (D-BSSE), ETH-Zurich, Switzerland.
authors: Boon Chin
authors: BC
authors: Heng
authors: Department of Sports Medicine, School of Medicine, Zhejiang University, Zhejiang 310000, China; Center for Stem Cell and Tissue Engineering, School of Medicine, Zhejiang University, Zhejiang 310000, China.
authors: Junfeng
authors: J
authors: Ji
authors: Department of Orthopedic Surgery, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang 310009, China. Electronic address: chenweishan@zju.edu.cn.
authors: Weishan
authors: W
authors: Chen
authors: Department of Sports Medicine, School of Medicine, Zhejiang University, Zhejiang 310000, China; Zhejiang Key Laboratory for Tissue Engineering and Repair Technology, School of Medicine, Zhejiang University, Zhejiang 310009, China; Center for Stem Cell and Tissue Engineering, School of Medicine, Zhejiang University, Zhejiang 310000, China. Electronic address: hongweiouyang@yahoo.com.cn.
authors: Hong-Wei
authors: HW
authors: Ouyang
mesh_terms: D000818:Animals; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D001672:Biocompatible Materials / Q000737:chemistry*; D001696:Biomechanical Phenomena; D012831:Bombyx; D049109:Cell Proliferation; D003094:Collagen / Q000737:chemistry*; D008022:Ligaments; D008422:Materials Testing; D008855:Microscopy, Electron, Scanning; D046529:Microscopy, Electron, Transmission; D010003:Osteoarthritis / Q000517:prevention & control*; D011817:Rabbits; D047011:Silk / Q000737:chemistry*; D055114:X-Ray Microtomography
chemical_list: D001672:Biocompatible Materials; D047011:Silk; D003094:Collagen
keywords: Anterior cruciate ligament; Knitted silk–collagen sponge scaffold; Long-term effects; Osteoarthritis prevention; Regeneration