Abstract
IntroductionAcellular scaffolds are increasingly used for the surgical repair of tendon injury and ligament tears. Despite this increased use, very little data exist directly comparing acellular scaffolds and their native counterparts. Such a comparison would help establish the effectiveness of the acellularization procedure of human tissues. Furthermore, such a comparison would help estimate the influence of cells in ligament and tendon stability and give insight into the effects of acellularization on collagen.Material and MethodsEighteen human iliotibial tract samples were obtained from nine body donors. Nine samples were acellularized with sodium dodecyl sulphate (SDS), while nine counterparts from the same donors remained in the native condition. The ends of all samples were plastinated to minimize material slippage. Their water content was adjusted to 69%, using the osmotic stress technique to exclude water content-related alterations of the mechanical properties. Uniaxial tensile testing was performed to obtain the elastic modulus, ultimate stress and maximum strain. The effectiveness of the acellularization procedure was histologically verified by means of a DNA assay.ResultsThe histology samples showed a complete removal of the cells, an extensive, yet incomplete removal of the DNA content and alterations to the extracellular collagen. Tensile properties of the tract samples such as elastic modulus and ultimate stress were unaffected by acellularization with the exception of maximum strain.DiscussionThe data indicate that cells influence the mechanical properties of ligaments and tendons in vitro to a negligible extent. Moreover, acellularization with SDS alters material properties to a minor extent, indicating that this method provides a biomechanical match in ligament and tendon reconstruction. However, the given protocol insufficiently removes DNA. This may increase the potential for transplant rejection when acellular tract scaffolds are used in soft tissue repair. Further research will help optimize the SDS-protocol for clinical application.
Highlights
Acellular scaffolds are increasingly used for the surgical repair of tendon injury and ligament tears
Acellularization with sodium dodecyl sulphate (SDS) alters material properties to a minor extent, indicating that this method provides a biomechanical match in ligament and tendon reconstruction
Comparison of the anthropometric data from the body donors revealed that their age, body length and weight did not significantly vary among the specimens used for the osmotic stress experiments, the mechanical testing and the DNA assay
Summary
Acellular scaffolds are increasingly used for the surgical repair of tendon injury and ligament tears Despite this increased use, very little data exist directly comparing acellular scaffolds and their native counterparts. Very little data exist directly comparing acellular scaffolds and their native counterparts Such a comparison would help establish the effectiveness of the acellularization procedure of human tissues. An additional aim is to slow down physiological degradation and to enhance ingrowth of the body’s own cells. For this purpose, the scaffolds are chemically cross-linked [3,7,8] or seeded with growth factors [9]. These tissues mostly originate from human, bovine, caprine, equine or porcine donors [15]
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