Enhanced osteointegration of the ligament through a tailored local osteoinductive product delivery
Résumé
Tear of the Anterior Cruciate Ligament (ACL) is one of the most common knee injuries, which lead frequently to a surgery for recovery, due to the poor capacity of self-healing of the ligament1. The standard ACL reconstruction (ACLR) procedure uses an auto- or allograft harvested from the hamstring or patellar tendon. An alternative is to do the ACLR with a synthetic graft, which is introduced during the surgery through tunnels drilled in the tibial and the femoral bone to reproduce the natural anchoring of the ligament2. Although those ligaments provide high biomechanical properties, their poor biocompatibility can cause the widening of the bone tunnels due to a loose connection between the new ligament and the bone3. Hence, the solution we propose here is modify the ends of the artificial ligament with a core-sheath structure including a core braid loaded with bioactive glass (BG) and an overbraid with a windowed pattern that prevent the leak of bioactive glass and allow the osteoinduction through. This structure is designed to induce an optimal anchoring of the ligament in the neobone formed inside and outside the core-sheath ligament. The first goal of this study was to ensure the reliability of the protocol of BG incorporation to the device. The second goal was to induce biomineralization and to evaluate different sheath braid patterns to see how they allow the external growth throughout the windowed structure. Furthermore, we will also evaluate the cytotoxicity towards osteoblast cells.