Background
Recently, ligament bracing as a treatment for acute ligament tears in multiple joints has emerged. An outstanding advantage is that the applied suture material is in close proximity to the injured ligaments. The purpose was to evaluate the response of human ligamentocytes (HLs) and osteoblasts (HOBs) after biological augmentation with thrombin, concentrated bone marrow aspirate (cBMA), or platelet rich plasma (PRP) on two different types of suture material used for ligament bracing.
Methods
Uncoated (U) and collagen-coated (C) suture tapes were augmented with either thrombin (T), cBMA (B), PRP (P), or a combination of these three (A), while platelet poor plasma was used as a source for fibrin (F) in each assay. Previously cultured HLs and HOBs were added with a defined density and assayed after the required time period for adhesion, proliferation, and alkaline phosphatase activity, respectively.
Results
Biological augmentation of uncoated [(UFT, UFBT, UFA: p<0.001), (UFPT: p=0.017)] and collagen coated suture (CFT, CFPT, CFBT, CFA: p<0.001) lead to a significantly higher HLs adhesion. Significantly higher adhesion (UFT, UFPT, UFBT, UFA: p<0.001; CFT, CFPT, CFBT, CFA: p<0.001) was also observed for HOBs. Similarly, HLs proliferation [(UFT, UFPT, UFA: p=0.009), (UFBT: p=0.001); (CFT: p=0.009), (CFBT: p=0.001), (CFA: p=0.01)] was significantly higher. HOBs showed significantly higher proliferation [(UFT, UFPT, UFA: p=0.002), (UFBT: p=0.001); CFT: p=0.003), (CFPT, CFBT, CFA: p=0.001)] as well. Augmentation with thrombin, PRP, and BMA for uncoated (UFT: p=0.006, UFPT: p=0.035, UFBT: p=0.001) and BMA (CFBT: p=0.027) for coated suture tape led to significantly higher alkaline phosphatase activity.
Conclusion
Biological enhancement of suture material used for ligament bracing leads to a significant increase in HLs as well as HOBs adhesion, proliferation, and alkaline phosphatase activity. Furthermore, no overall superiority between uncoated or collagen-coated suture material was observed. The biological augmentation of suture material used for ligament bracing may improve the healing of injured ligaments in addition to providing immediate biomechanical stabilization.