Next generation tissue engineering of orthopedic soft tissue-to-bone interfaces
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iomaterials for 3D Cell Biology Prospective Article
Next generation tissue engineering of orthopedic soft tissue-to-bone interfaces Alexander J. Boys†, Department of Materials Science and Engineering, Cornell University, Ithaca, New York, USA Mary Clare McCorry†, Meinig School of Biomedical Engineering, Cornell University, Ithaca, New York, USA Scott Rodeo, Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA; Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, New York, USA; Tissue Engineering, Regeneration, and Repair Program, Hospital for Special Surgery, New York, New York, USA; Orthopedic Surgery, Weill Medical College of Cornell University, Cornell University, New York, New York, USA; New York Giants, East Rutherford, New Jersey, USA; Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA Lawrence J. Bonassar, Meinig School of Biomedical Engineering, Cornell University, Ithaca, New York, USA; Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, New York, USA Lara A. Estroff, Department of Materials Science and Engineering, Cornell University, Ithaca, New York, USA; Kavli Institute at Cornell, Cornell University, Ithaca, New York, USA Address all correspondence to Lawrence J. Bonassar at [email protected] and Lara A. Estroff at [email protected] (Received 18 May 2017; accepted 28 August 2017)
Abstract Soft tissue-to-bone interfaces are complex structures that consist of gradients of extracellular matrix materials, cell phenotypes, and biochemical signals. These interfaces, called entheses for ligaments, tendons, and the meniscus, are crucial to joint function, transferring mechanical loads and stabilizing orthopedic joints. When injuries occur to connected soft tissue, the enthesis must be re-established to restore function, but due to structural complexity, repair has proven challenging. Tissue engineering offers a promising solution for regenerating these tissues. This prospective review discusses methodologies for tissue engineering the enthesis, outlined in three key design inputs: materials processing methods, cellular contributions, and biochemical factors.
Introduction Soft tissue-to-bone interfaces are present in many tissues, supporting movement in vertebrate animals. These interfaces mediate transitions between materials with highly dissimilar mechanical properties, with a three or more order of magnitude change in stiffness occurring over only a few hundred microns.[1–3] While these interfaces are robust, undergoing wear and tear over the entire lifespan of humans, they fail in instances of extreme joint loading. Tissue engineered replacements can be constructed outside of the body and implanted as living tissue, offering a promising alternative to current repair options. This review discusses the structure and development of some representative orthopedic interfaces in the body (e.g., ligamentous, tendinous, and meniscal attachments) and how we can use this information to engineer living t
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