Journal
JOURNAL OF ORTHOPAEDIC RESEARCH
Volume 31, Issue 10, Pages 1501-1506Publisher
WILEY-BLACKWELL
DOI: 10.1002/jor.22420
Keywords
anterior cruciate ligament; reconstruction; repair; in vivo; osteoarthritis
Categories
Funding
- Orthopaedic Research and Education Foundation
- National Institutes of Health [R03-AR046356, K02-AR049346, R01-AR054099, R01-AR049199, R01-AR056834, R01-AR056834S1]
- NFL Medical Charities
- Department of Defense (The Center for Innovative and Minimally Invasive Technology-CIMIT) [DAMD17-02-2-0006]
- Children's Hospital Orthopaedic Surgery Foundation
- Lucy Lippitt Endowed Professorship
- RIH Orthopaedic Foundation
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Anterior cruciate ligament (ACL) injuries are currently treated by removing the injured ligament and replacing it with a tendon graft. Recent studies have examined alternative treatment methods, including repair and regeneration of the injured ligament. In order to make such an approach feasible, a basic understanding of ACL biology and its response to injury is needed. Identification of obstacles to native ACL healing can then be identified and potentially resolved using tissue engineering strategiesfirst, with in vitro screening assays, and then with in vivo models of efficacy and safety. This Perspectives paper outlines this path of discovery for optimizing ACL healing using a bio-enhanced repair technique. This journey required constructing indices of the functional tissue response, pioneering physiologically based methods of biomechanical testing, developing, and validating clinically relevant animal models, and creating and optimizing translationally feasible scaffolds, surgical techniques, and biologic additives. Using this systematic translational approach, bio-enhanced ACL repair has been advanced to the point where it may become an option for future treatment of acute ACL injuries and the prevention of subsequent post-traumatic osteoarthritis associated with this injury. (c) 2013 Orthopaedic Research Society Published by Wiley Periodicals, Inc. J Orthop Res 31:1501-1506, 2013
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