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Table 8 Performance of composites, blends and hybrid materials based on natural and synthetic polymers for ligament/tendon TE

From: Biodegradable polymer nanocomposites for ligament/tendon tissue engineering

MaterialScaffoldApplicationIn vivo/in vitroMechanical performanceBiological PerformanceRefs.
Young’s modulus (MPa)Stiffness (N/mm)Max. strength (MPa)Max. load (N)
CHI-PCL-celluloseElectrospun CHI-PCL nanofibers + cellulose nanocrystals: i) Aligned nanofibers
(ii) Random nanofibers
TendonIn vitro (human tenocytes)(i) 540.5 ± 83.7
(ii) ND
ND(i) 39.3 ± 1.9
(ii) ND
NDCellular adhesion/spread
(i) Cells elongated/aligned along the nanofibers
(ii) Cells with random shape and orientation
Synthesis of tendon-specific markers
[83]
Silk-PLCLElectrospun
(i) Aligned nanoyarn-reinforced random fibers (NRS)
(ii) Random nanofibers
(iii) Aligned nanofibers
In vitro (primary rat BMSCs)(i) 288.95 ± 13.26
(ii) 186.65 ± 8.87
(iii) 433.56 ± 48.06
ND(i) 24.25 ± 0.76
(ii) 9.70 ± 0.51
(iii) 39.10 ± 2.89
NDBMSCs adhesion/spread
(i) Higher cell spread than (ii), (iii); cells elongation/random distribution
(ii) Cells with random distribution, pyramidal shape
(iii) Cellular elongation
[106]
Col-PLCLElectrospun
(i) Nanoyarn
(ii) Random nanofibers
(iii) Aligned nanofibers
In vitro (primary rabbit tendon cells)(i) ~ 2.1
(ii) ~ 3.9
iii) ~ 4.5
ND(i) ~ 3.3
(ii) ~ 5.6
(iii) ~ 6.2
NDCell adhesion, spread
(i) Higher cell growth
(i), (ii) Elongation along the nanofibers/nanoyarn
(iii) Cells with random spread
(i) Higher tendon-ECM genes, compared to (ii), (iii), after 14 days
[107]
Col-PDaElectrospun
(i) Col nanofibers
(ii) Col microfibers coated with PD
TendonIn vivo, rabbit model(i) 0.549
(ii) 0.754 (60 days post surgery)
(i) 20.37
ii) 29.87 (60 days post surgery)
i) 10.44
(ii) 11.37 (60 days post surgery)
(i) 52.72
(ii) 74.02 (60 days post surgery)
(i), (ii) Some inflammatory response, after surgery
(ii) Cells with better alignment and higher mature tenoblasts and macrophages, compared to (i), 60 days post-surgery; Scaffold partially degraded
[119]
Col-Carbon nanofibersElongated gel-spun fibers: (i) Col/ 0.5 carbon nanochips crosslinked with glutaraldehyde
(ii) Col/ 0.5 carbon nanochips
(iii) Col/ 0.5SWNTsb, crosslinked with glutaraldehyde
(iv) Col/ 0.5SWNTs
ND(i) 590 ± 50
(ii) 46 ± 4
(iii) 840 ± 40
(iv) 92 ± 35 (wet-state)
ND(i) 75 ± 15
(ii) 5 ± 2
(iii) 70 ± 8
(iv) 9 ± 1 (wet-state)
NDND[109]
(PLLA-Col)-(PCL-Col)Co-electrospun onto opposite ends: PLLA-Col
PCL-Col (3 regions)
In vitro (myoblastsand fibroblasts)7.34 ± 2.13ND0.51 ± 0.21NDMyoblasts and fibroblasts adhesion/proliferation onto the 3 regions
Myoblasts differentiation into myotubes
[108]
Silk coated with PLGAKnitted silk microfibers coated withRandom electrospun PLGA nanofibersLigament/tendonIn vitro (rabbit BMSCs)ND4.8 ± 0.52NDCellular adhesion, proliferation
Production of ECM between the nanofibers
[120]
(i) bFGF-releasing electrospun PLGA nanofibers
(ii) Electrospun PLGA nanofibers
ND(i) 4.3 ± 0.3
(ii) ND
NDCell adhesion/spread
(i) Higher cell proliferation, viability; higher Col production, ligament/tendon-specific ECM, from day 7 to 14, comparing to (ii)
[105]
Silk coated with PCL or P3HBcTwisted nanofiber-coated silk yarn Nanofiber coating: (i) PCL
(ii) P3HB
(iii) Electrospun PLGA nanofibers
In vitro (L929 murine fibroblasts)ND(i) 110.5 ± 6.6
(ii) 97.6 ± 11.4
(iii) 92.6  ± 8.2
Cell adhesion/spread
Cell viability decreased from the 1st to 3rd day of culture; (i), (ii) Higher cell viability than (iii), after 3 days of culture
[121]
PCL coated with ColElectrospun PCL scaffold coated with: (i) Col
(ii) Col + bFGF
(iii) Col + hFF
(iv) Col + bFGF + hFF
LigamentIn vivo, rat modelND(i) 12.4 ± 3.8
(ii) 23.3 ± 8.1
iii) 4.4 ± 1.2
iv) 10.1 ± 2.1 (16 weeks post-surgery)
ND(i) 16.0 ± 3.4
(ii) 23.1 ± 6.1
(iii) 17 ± 6.9
(iv) 15.1 ± 4.9
(16 weeks post-surgery)
Cell proliferation and alignment along the fibers; Col deposition
(ii) Higher cell proliferation than (i), at 16 weeks post-surgery
(iii), (iv) No beneficial effect of hFF for regeneration
[80]
PLCL (85/15)-poly-l-lysine-HAMultilayer braid: (i) PLCL
(ii) PLCL+Poly-l-lysine
iii) PLCL + poly-l-lysine + HA
In vitro (human BMSCs and WJ-MSCsd)(i) 1616 ± 643
(ii) 1608 ± 156
(iii) 1758 ± 470
NDCell adhesion, proliferation, elongation and alignment; ECM synthesis on day 14; Metabolic activities decreased from (i) to (ii) and (iii)
(iii) Higher MSCs migration
[69]
PLLA-gelatin-ColGelatin-bFGF hydrogel sandwiched by Fn-coated PLLA braided scaffold, and wrapped with a Col membrane, reinforced with PLLA microspheresIn vivo, rabbit modelND~ 30NDAt 8 weeks post-surgery, great cell spread/migration; vascularization induced by bFGF; great Col and ECM synthesis[38]
  1. aPolydioxanone(PD); bSingle walled nanotubes (SWNTs); cpoly(3-hydroxybutyrate) (P3HB); dWharton’s jelly mesenchymal stem cells (WJ‐MSCs)