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Table 2 Performance of natural biodegradable polymers in ligament/tendon TE

From: Biodegradable polymer nanocomposites for ligament/tendon tissue engineering

MaterialScaffoldApplicationIn vivo/in vitroMechanical responseBiological responseRefs.
Young’s modulus (MPa)Stiffness (N/mm)Max. strength (MPa)Max. loada (N)
CollagenAligned parallel 200 extruded-crosslinked col fibers; coating with ColLigamentIn vitro (ACL and PT fibroblasts)NDNDCells adhesion, proliferation
ACL cells: ovoid shape; no alignment; PT cells: elongation
[46]
Aligned parallel 200 extruded-crosslinked Col fibersIn vivo, rabbit modelNDNDSkin/ACL fibroblasts survived 4-6 weeks, after implantation; scaffold resorption after 8 weeks[47]
(i) Extruded-crosslinked Col fibers from bovine Achilles tendon
(ii) Extruded-crosslinked Col fibers from rat tail tendon
(iii) Fiber-embedded gel scaffolds
In vitro (fibroblasts)(i) 359.6±
28.4
(ii) 995.1 ± 144
(iii) 83.4 ± 10.8
ND(i) 36.0 ± 5.40
(ii) 106.1 ± 13.90
(iii) 5.4 ± 0.4
NDNon-uniform cells distribution[45]
Braid-twist scaffold of extruded-crosslinked Col fiber i) with or ii) without gelatinIn vitro (primary rat ligament fibroblasts)(i) 6.32 ± 0.95
(ii) 148 ± 170
ND(i) 1.07 ± 0.06
(ii) 19.3 ± 3.10
NDCell adhesion, proliferation; only (ii) exhibited increased cellular activity after 21 days of culture[48]
Woven scaffold by electrochemically aligned Col threads (yarns)Tendon/tendonIn vitro (MSCs)~ 520ND~ 65NDMSCs adhesion, proliferation, elongation after 35 days in culture
Tendon-specific/related markers
[62]
Sponges (L/W/T = 23/9/3 mm)
i) Non-stimulated scaffolds
ii) Mechanically stimulated scaffolds
In vitro (rabbit MSCs)/In vivo, rabbit model(i) 343.2 ± 21.2
(ii) 441.2 ± 26.3
ND(i) 50.2 ± 9.2
(ii) 72.1 ± 11.1
(i) 271.5 ± 17.5
(ii) 339 ± 11.4
MSCs adhesion and alignment
(i) and (ii) excellent cellular alignment, after 12 weeks of culture
Tendon-related ECM components
[63]
SilkKnitted microporous silk mesh rolled up around a braided silk cordLigament/ligamentIn vitro (MSCs)/in vivo, pig modelND58.5 ± 17ND398 ± 70MSCs adhesion, proliferation, differentiation
Ligament-specific ECM markers at 24 weeks post-operatively
[50]
Wire rope–like scaffolds
(i) Cell seeded-scaffold
(ii) Non-seeded scaffold
In vivo (autologous stem cells), sheep modelND194 ± 27ND1450 ± 65(i) Higher cell content in the inner part, after 6 months
(i), (ii) Silk fiber degradation after 12 months
[53]
(i) Wire rope of multifiber
(ii) Parallel multifiber (theoretical)
In vitro (BMSCs)ND(i) 354 ± 26
(ii) 1740
ND(i) 2337 ± 72
(ii) 2214
(i) BMSCs adhesion, proliferation, differentiation
Ligament-specific markers, after 14 days of culture
(ii) ND
[16]
Knitted silk mesh integrated:
(i) Aligned electrospun fibers
(ii) Random electrospun fibers
(iii) Without fibers
In vitro (MSCs)ND(i) 22.12 ± 1.2
(ii) 19.21 ± 0.9
(iii) 16.24 ± 0.8
ND(i) 129 ± 7.4
(ii) 106 ± 6.2
(iii) 93.2 ± 5.6
(i) MSCs proliferation, elongation, orientation along the fibers; ligament-related proteins increased when compared to (ii) scaffolds[51]
Microporous silk sponges incorporated into a knitted silk scaffoldIn vitro (BMSCs and ACL fibroblasts)/in vivo, rabbit modelNDNDBMSCs with higher proliferation, ligament-related ECM markers and in vivo viability, comparing to ACL fibroblasts[56]
In vitro (MSCs)ND50 ± 4 (after 14 days of cell culture)ND257 ± 7 (after 14 days of cell culture)MSCs adhesion, proliferation
Ligament-specific ECM markers, after 15 days of culture
[64]
(i) Wired
(ii) Braided
In vitro (hFFb)ND(i) ~ 280
(ii) ~ 240 (wet)
ND(i) ~ 1560
(ii) ~ 1610
(wet)
Inconclusive cell invasion, proliferation[65]
(i) Silk
(ii) PBS
Extruded fibers in knitted scaffolds (weft knitting)Tendon/ligamentIn vitro (L929 fibroblasts)(i) 31.6
(ii) 7.9
ND(i) 17.4
(ii) 8.2
ND(i), (ii): L929 adhesion, proliferation
(i) Differentiation, after 14 days of culture; (ii) cells with rounder shape
[66]
HA (HYAFF 11®)Multilayered knitted cylindrical array of fibersLigamentIn vitro (MSCs)NDNDMSCs adhesion, proliferation, differentiation
Ligament-specific ECM markers
[43]
  1. amaximum tensile load (max. load); bhuman foreskin fibroblasts (hFF)