Knee Ligament Injury and the Clinical Application of Tissue Engineering Techniques: A Systematic Review

Title:Knee Ligament Injury and the Clinical Application of Tissue Engineering Techniques: A Systematic Review

Volume: 13 Issue: 3

Author(s): Thomas C. Riley, Reza Mafi*, Pouya Mafi and Wasim S. Khan

Affiliation:

• Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, OX3 7LD,United Kingdom

Keywords: Extracellular matrix, fibroblast, growth factors, knee ligament, scaffold, stem cells, tissue engineering.

Abstract: Background: The incidence of knee ligament injury is increasing and represents a significant cost to healthcare providers. Current interventions include tissue grafts, suture repair and non-surgical management. These techniques have demonstrated good patient outcomes but have been associated graft rejection, infection, long term immobilization and reduced joint function. The limitations of traditional management strategies have prompted research into tissue engineering of knee ligaments.

Objective: This paper aims to evaluate whether tissue engineering of knee ligaments offers a viable alternative in the clinical management of knee ligament injuries. A search of existing literature was performed using OVID Medline, Embase, AMED, PubMed and Google Scholar, and a manual review of citations identified within these papers.

Results: Silk, polymer and extracellular matrix based scaffolds can all improve graft healing and collagen production. Fibroblasts and stem cells demonstrate compatibility with scaffolds, and have been shown to increase organized collagen production. These effects can be augmented using growth factors and extracellular matrix derivatives. Animal studies have shown tissue engineered ligaments can provide the biomechanical characteristics required for effective treatment of knee ligament injuries.

Conclusion: There is a growing clinical demand for a tissue engineered alternative to traditional management strategies. Currently, there is limited consensus regarding material selection for use in tissue engineered ligaments. Further research is required to optimize tissue engineered ligament production before clinical application. Controlled clinical trials comparing the use of tissue engineered ligaments and traditional management in patients with knee ligament injury could determine whether they can provide a cost-effective alternative.

Cite this article as:

Riley C. Thomas , Mafi Reza *, Mafi Pouya and Khan S. Wasim , Knee Ligament Injury and the Clinical Application of Tissue Engineering Techniques: A Systematic Review, Current Stem Cell Research & Therapy 2018; 13 (3) . https://dx.doi.org/10.2174/1574888X12666170915120135