2023 ISAKOS Biennial Congress ePoster
Fabrication of Bioactive Collagen Rope For ACL Reconstruction
Ming-Hao Zheng, PhD, DM, FRCPath, FRCPA, Crawley, WA AUSTRALIA
Peilin Chen, MB, PhD, Perth, WA AUSTRALIA
Ziming Chen, MB, MMed, Perth, WA AUSTRALIA
Euphemie Bassonga, BSc, MMSc, Perth, WA AUSTRALIA
Toby Leys, MBBS, FRACS, FAOrthA, Claremont, WA AUSTRALIA
Tao Wang, PhD, BEng, Perth, WA AUSTRALIA
The University of Wester Australia , Perth, WA, AUSTRALIA
FDA Status Not Applicable
Summary
New approach for ACL reconstruction using braided collagen rope
ePosters will be available shortly before Congress
Abstract
Introduction
Current ACL reconstruction using either autologous tissue or synthetic materials has concerns of donor site morbidity and/or chronic immune rejection. Collagen based materials are considered to be an ideal alternative for ACL reconstruction, but they do not have sufficient mechanical properties for ACL reconstruction. To address the current challenge of anterior cruciate ligament (ACL) reconstruction, this study is the first to fabricate a braided collagen rope (BCR) which mimics native hamstring for ACL reconstruction. The study aims to evaluate the biological and biomechanical properties of BCR both in vivo and vitro.
Methods
Rabbit ACL reconstruction model using collagen rope and autograft (hamstring tendon) was conducted. The histological and biomechanical evaluations were conducted at 6-, 12-, 18, 26-week post-operation. In vitro study included cell morphology analysis, cell function evaluation and RNA sequencing of the tenocytes cultured on BCR. A cadaver study was also conducted to verify the feasibility of BCR for ACL reconstruction.
Results
BCR displays satisfactory mechanical strength similar to hamstring graft for ACL reconstruction in rabbit. Histological assessment showed that BCR restores ACL morphology at 26 weeks almost similar to native ACL. The superior dynamic ligamentization in BCR over autograft group was evidenced by assessment of cell and collagen morphology and orientation. The in vitro study showed that the natural collagen fibres within BCR enable to signal the morphology adaptation and orientation of human tenocytes in bioreactor. Co-culture of BCR with tendon cells showed that BCR enables to enhance cell proliferation and tenogenic expression of tenocytes as compared to hydrolysed collagen. We next performed an RNA-Sequencing (RNA-seq) experiment where RNA was extracted from tenocyte seeded with BCR. Analysis of enriched pathways of the up-regulated genes revealed that the most enriched pathways were the Hypoxia-inducible factor 1-alpha (HIF1A) regulated networks, implicating the possible mechanism of BCR induced ACL regeneration. The subsequent cadaver study was also conducted to proof the mechanical properties of BCR for ACL reconstruction in human.
Conclusion
This study demonstrated proof-of-concept of bio-textile braided collagen rope for ACL reconstruction, and the mechanism by which BCR induces tendon/ligament formation.