Biomedical Engineering Reference
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Figure 34.4. Design of extensor tendon complex scaffold. (a) Schema
chart showing the central slip and two lateral bands. (b) PGA scaf-
fold secured on a custom-made spring to mimic the complex structure.
(Reprinted by permission from Ref. 13).
biodegradability with proper degradation rate, biofunctionality for
supporting cell growth and matrix production, and processability.
However, an obvious disadvantage of unwoven fibers is the lack of
proper mechanical support during tendogenesis; therefore, an acel-
lular small intestinal submucosa membrane was needed to wrap
around the cell-loaded PGA fibers in order to enhance the mechani-
cal property of the cell-scaffoldconstructs. 11 , 12
In a recent study performed in our center, we tried to under-
stand what would be the optimal condition for tissue-engineering-
mediated tendogenesis. 13 In this study, long PGA fibers and human
fetal extensor tenoctyes (isolated from a three-month-old aborted
fetus donated by the patients for research only) were used to engi-
neer an extensor tendon equivalent. The long PGA fibers were
arranged to mimic the extensor tendon complex-like structure
(Fig. 34.4) followed by cell seeding onto the scaffold.
After in vitro culture for six weeks, the cell-scaffold constructs
were further divided into three groups: (1) in vitro culture with
mechanical loading, (2) in vivo implantation without mechanical
loading; and (3) in vivo implantation with mechanical loading by
suturing the construct to fascia. And thus mouse movement can
provide a natural dynamic loading. The results showed that human
fetal cells could form an extensor tendon complex structure in vitro
and become further matured in vivo by mechanical stimulation.
In contrast to in vitro -loaded and in vivo -nonloaded tendons, in
vivo -loaded tendons exhibited bigger tissue volume, better aligned
 
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