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Table 4 Performance of synthetic 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. load (N)
PLGA(i) Electrospun PLGA fibers onto knitted PLGA
(ii) Knitted PLGA scaffold
Ligament/tendonIn vitro (porcine BMSCs) (i) 0.85 ± 0.2
(ii) 0.64 ± 0.2 (at 14 days of culture)
ND(i) Higher BMSCs attachment, proliferation, ECM deposition compared to (ii)[71]
Electrospun Aligned
(i) Nanofiber
diameter (320,680 nm)
(ii) Microfiber diameter (1.8 µm)
In vitro (Human rotator cuff fibroblast)(i) 421 ± 23
(ii) 510 ± 32
(for 1.8 µm)
ND(i) ~ 13
(ii) ~ 14
(for 1.8 µm)
ND(i) Higher cells proliferation
(ii) Higher tendon-related ECM markers, after 14 days of culture
[87]
Electrospun
(i) Aligned nanofibers
(ii) Random nanofibers
TendonIn vitro (Human rotator cuff fibroblast)(i) 341 ± 30
(ii) 107 ± 23
ND(i) 12.0 ± 1.5
(ii) 3.7 ± 0.2
NDCellular adhesion, proliferation
(i) Elongated morphology and orientation along the fibers
(ii) Polygonal shape, random orientation
[70]
(i) Rectangular braid
(ii) Circular braid (scaffold with 3 regions)
LigamentIn vitro (fibroblasts: rabbit ACL; mouse BALB/C)ND(i) 217 ± 11
(ii) 212 ± 25
(i) 705 ± 36
(ii) 907 ± 132
Cellular adhesion and proliferation
(i) ACL and BALB/C spread along the fibers
(ii) Only ACL proliferate along the fibers
[6]
PLLARectangular braid (scaffold with 3 regions)Ligament/tendonIn vitro (rabbit ACL; MCL;AT; PT fibroblast)NDCellular adhesion, proliferation, elongation along the fibers
ACL with higher matrix production
[11, 74]
Braided scaffolds of (i) 3, (ii) 4; (iii) 5 aligned electrospun nanofibersIn vitro (human MSCs)(i) 55.0 ± 2.8
(ii) 47.8 ± 7.5
(iii) 47.6 ± 2.8
ND(i) 7.62 ± 0.2
(ii) 6.57 ± 0.5
(iii) 6.67 ± 0.4
ND(i) hMSCs adhesion and proliferation, orientation along the fibers; Expression of pluripotency genes
(ii), (iii) ND
[88]
(i) Braided scaffold
(ii) Twisted fiber scaffold
(iii) Braid-twist scaffold
LigamentIn vitro (rabbit PT fibroblasts)(i) 810.2 ± 233.5
(ii) 888.2 ± 60.7; (iii) 428.2 ± 60.7
ND(i) ~ 52.3 ± 7.7
(ii) 80.9 ± 6.9
(iii) 81.6 ± 1.6
ND(i), (iii) Comparable cellular adhesion, proliferation. Production of ECM, after 7 days of culture
(ii) ND
[75, 89]
5 × 5 Square braid:
(i) Scaffold before implantation
(ii) Seeded
(iii) Unseeded
(i), (ii) 4 weeks post-surgery)
In vivo (after seeded with primary rabbit ACL cells) rabbit model(i) 354.4 ± 68.5
(ii) 108.4 ± 27.7
(iii) 103.0 ± 53.9
ND(i) 332.2 ± 19.6
(ii) 239.0 ± 43
(iii) 209.0 ± 73.5
(i) ND
(ii) After 12 weeks, vascularization and greater tissue ingrowth and alignment of collagen fibers compared to (iii) A mild inflammatory response was observed in (i) and (ii)
[76]
Electrospun
(i) Aligned
(ii) Random nanofibers
TendonIn vitro/in vivo, (human tendon stem cells (hTSCs))
mouse model
(i) 22.76 ± 5.63
(ii) 0.63 ± 0.56
NDhTSCs adhesion, proliferation
In vitro/in vivo (i) cells with spindle-shaped and well orientated; teno-lineage differentiation
(ii) Cells with round shapes; random distribution
[90]
(i) PLLA
(ii) PLGA
(iii) PGA
(iv) Fn pre-coated: (i)–(iii)
Circular braid (multi-filament yarns-3 regions)LigamentIn vitro (rabbit ACL fibroblasts)ND(i) 165 ± 33
(ii) 117 ± 12
(iii) 378 ± 18
(iv) ND
(i) 298 ± 59
(ii) 215 ± 23;
(iii) 502 ± 24
(iv) ND
ACL adhesion, proliferation
(i) Cells with spindle-like morphology
(ii) Cells with a form of spiked rods
(iii) Cells form large globular aggregates
(iv) Higher ECM production; Fn improved cellular proliferation mainly on i)
[72]
PCLFUV-crosslinked PCLF solution injected over
3D printed mold-square porous: (i) 500 × 500 µm
(ii) 750 × 750 µm (mold designed by SolidWorks CAD software)
LigamentIn vitro (AMSCs)ND(i), (ii) AMSCs adhesion and proliferation, filling the pores, after 14 days of culture
Expression of ligament-ECM in the presence of growth factors
[86]
PCLTwisted electrospun fibers
(i) Under static conditions
(ii) Dynamic Loading
TendonIn vitro (human MSCs)(i) ~ 34 ± 6.8
(ii) ~ 27 ± 6.8 (acellular, after 21 days)
ND(i) ~ 13 ± 0.7
(ii) ~ 12 ± 1.4 (acellular, after 21 days)
NDCellular adhesion/proliferation
Elongated cells along the fiber direction
(ii) Textured/round cells; Higher cell proliferation, comparing to (i)
(i) Cells flatter and fused together
(ii) Up-regulation of tendon genes, after 21 days
[91]