Biomedical Engineering Reference
In-Depth Information
Chapter 15
Engineering Fibrous Tissues
and Their Interfaces with Bone
Jennifer Lei and Johnna S. Temenoff
15.1
Introduction
Each year, musculoskeletal injuries in the United States (of which 45% result in
damage to tendons and ligaments) result in costs of approximately $30 billion [
1
].
Surgical treatment is necessary in fibrous tissue injuries because tendons and
ligaments are relatively non-vascular and acellular, making natural healing slow
and ineffective [
2
,
3
]. Unfortunately, surgical repair using autografts, or graft tissue
from the injured patient, can create problems of donor site morbidity. Additionally,
surgical repair using allografts, or frozen tissues taken from cadavers, can poten-
tially induce an immune response [
4
-
6
]. For these reasons, significant research on
tissue engineering of fibrous tissues and their interface to bone is underway with the
goal of generating new methods for injured tendon and ligament regeneration.
Tissue engineering combines the use of cells, scaffolds, and exogenous factors.
However, before these techniques are implemented in the clinic, it is important to
optimize the cell types, materials, and external factors to best recreate and regener-
ate the tissue.
To successfully design a tissue-engineered replacement, the normal function,
structure, and mechanical properties of the tendon or ligament must be understood
and mimicked. The process of tendon and ligament healing is also an important
factor in developing tissue engineering approaches because diverse injuries and
subsequent secondary pathologies require different methods of regeneration.
Furthermore, next-generation tissue-engineered graft alternatives must consider
J. Lei
George W. Woodruff School of Mechanical Engineering, Georgia Institute
of Technology and Emory University, Atlanta, GA, USA
J.S. Temenoff (
*
)
Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute
of Technology and Emory University, Atlanta, GA, USA
e-mail:
johnna.temenoff@bme.gatech.edu
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