Ligament Tissue Engineering: The Anterior Cruciate Ligament

Abstract

Abstract: Due to ongoing problems with reconstructive surgery and recent advancements in the field of musculoskeletal tissue engineering, regeneration of ligaments in general and of the anterior cruciate ligament (ACL) in particular has gained an increasing research interest. It is the aim of this chapter to review the current research efforts and highlight promising ligament engineering strategies. The four main components of tissue engineering also apply to several ligament regeneration research efforts. Scaffolds are made of biologic materials, biodegradable polymers, and composite materials. The main cell sources are mesenchymal stem cells and ACL fibroblasts. In addition, growth factors and mechanical stimuli are applied. So far, the regenerated ACL constructs have been tested in few in vivo studies, and the results are encouraging although the real breakthrough has not been achieved thus far. The different strategies reaching from in vitro ACL regeneration in bioreactor systems to bio-enhanced repair and true regeneration are under constant development. We expect considerable progress in the near future that will result in a realistic option for ligament reconstructive surgery soon.