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Li S, Wang S, Shao J, Wang J, Liu W, Chen L, Li Z, Zhang C, Song J. Toward the Improvement of the Mechanical and Tribological Properties of Braided Ligament for ACL Reconstruction: A "Carrot and Stick" Strategy. Adv Healthc Mater 2024; 13:e2304133. [PMID: 38484144 DOI: 10.1002/adhm.202304133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 02/21/2024] [Indexed: 05/03/2024]
Abstract
Bone tunnel enlargement has been troubling the clinical adoption of braided artificial ligaments for decades, to which mechanical and tribological performance promotion shall be an effective and promising approach. Herein, a "carrot and stick" strategy has been introduced with two types of polyethylene terephthalate (PET) fibers to fabricate hybrid textures, which is expected to advance fatigue and tribological performance without yielding essential mechanical strength and biocompatibility. Owing to advancements in such a "carrot and stick" strategy, the obtained grafts present three promising properties: i) enhancement of mechanical strength; ii) coefficient of friction (COF) reduction of 25% at the greatest extent, thus lowering the risk of bone tunnel enlargement; iii) final displacement shrinkage of graft length after cyclic loadings, favored in the clinic for isometric reconstruction. The results obtained in this study show that the "carrot and stick" strategy can be a creative and convenient method to optimize the service life, saving the complication rate of artificial ligaments for clinical applications.
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Affiliation(s)
- Shenglin Li
- School of Biomedical Engineering, Shenzhen Campus of Sun Yat-sen University, Shenzhen, 518107, China
- Shenzhen Institute for Drug Control, Shenzhen Testing Center of Medical Devices, Shenzhen, 518057, China
| | - Shuhan Wang
- Shenzhen Institute for Drug Control, Shenzhen Testing Center of Medical Devices, Shenzhen, 518057, China
| | - Jiasheng Shao
- School of Biomedical Engineering, Shenzhen Campus of Sun Yat-sen University, Shenzhen, 518107, China
| | - Jiali Wang
- School of Biomedical Engineering, Shenzhen Campus of Sun Yat-sen University, Shenzhen, 518107, China
| | - Wenliang Liu
- Shenzhen Institute for Drug Control, Shenzhen Testing Center of Medical Devices, Shenzhen, 518057, China
| | - Linxin Chen
- School of Biomedical Engineering, Shenzhen Campus of Sun Yat-sen University, Shenzhen, 518107, China
| | - Zeng Li
- Department of Orthopedics, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China
| | - Chao Zhang
- School of Biomedical Engineering, Shenzhen Campus of Sun Yat-sen University, Shenzhen, 518107, China
| | - Jian Song
- School of Biomedical Engineering, Shenzhen Campus of Sun Yat-sen University, Shenzhen, 518107, China
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Wang L, Jiang H, Wan F, Sun H, Yang Y, Li W, Qian Z, Sun X, Chen P, Chen S, Peng H. High-Performance Artificial Ligament Made from Helical Polyester Fibers Wrapped with Aligned Carbon Nanotube Sheets. Adv Healthc Mater 2023; 12:e2301610. [PMID: 37717208 DOI: 10.1002/adhm.202301610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 09/09/2023] [Indexed: 09/18/2023]
Abstract
Repairing high-load connective tissues, such as ligaments, by surgically implanting artificial grafts after injury is challenging because they lack biointegration with host bones for stable interfaces. Herein, a high-performance helical composite fiber (HCF) ligament by wrapping aligned carbon nanotube (CNT) sheets around polyester fibers is proposed. Anterior cruciate ligament (ACL) reconstruction surgery shows that HCF grafts could induce effective bone regeneration, thus allowing the narrowing of bone tunnel defects. Such repair of the bone tunnel is in strong contrast to the tunnel enlargement of more than 50% for commercial artificial ligaments made from bare polyester fibers. Rats reconstructed with this HCF ligament show normal jumping, walking, and running without limping. This work allows bone regeneration in vivo through a one-step surgery without seeding cells or transforming growth factors, thereby opening an avenue for high-performance artificial tissues.
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Affiliation(s)
- Liyuan Wang
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Institute of Fiber Materials and Devices, and Laboratory of Advanced Materials, Fudan University, Shanghai, 200438, China
| | - Hongyu Jiang
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Institute of Fiber Materials and Devices, and Laboratory of Advanced Materials, Fudan University, Shanghai, 200438, China
| | - Fang Wan
- Department of Orthopedic Sports Medicine, Huashan Hospital, The Sports Medicine Institute, Fudan University, Shanghai, 200433, China
| | - Hongji Sun
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Institute of Fiber Materials and Devices, and Laboratory of Advanced Materials, Fudan University, Shanghai, 200438, China
| | - Yiqing Yang
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Institute of Fiber Materials and Devices, and Laboratory of Advanced Materials, Fudan University, Shanghai, 200438, China
| | - Wenjun Li
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Institute of Fiber Materials and Devices, and Laboratory of Advanced Materials, Fudan University, Shanghai, 200438, China
| | - Zheyan Qian
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Institute of Fiber Materials and Devices, and Laboratory of Advanced Materials, Fudan University, Shanghai, 200438, China
| | - Xuemei Sun
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Institute of Fiber Materials and Devices, and Laboratory of Advanced Materials, Fudan University, Shanghai, 200438, China
| | - Peining Chen
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Institute of Fiber Materials and Devices, and Laboratory of Advanced Materials, Fudan University, Shanghai, 200438, China
| | - Shiyi Chen
- Department of Orthopedic Sports Medicine, Huashan Hospital, The Sports Medicine Institute, Fudan University, Shanghai, 200433, China
| | - Huisheng Peng
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Institute of Fiber Materials and Devices, and Laboratory of Advanced Materials, Fudan University, Shanghai, 200438, China
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Wang L, Wan F, Xu Y, Xie S, Zhao T, Zhang F, Yang H, Zhu J, Gao J, Shi X, Wang C, Lu L, Yang Y, Yu X, Chen S, Sun X, Ding J, Chen P, Ding C, Xu F, Yu H, Peng H. Hierarchical helical carbon nanotube fibre as a bone-integrating anterior cruciate ligament replacement. NATURE NANOTECHNOLOGY 2023; 18:1085-1093. [PMID: 37142709 DOI: 10.1038/s41565-023-01394-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 03/31/2023] [Indexed: 05/06/2023]
Abstract
High rates of ligament damage require replacements; however, current synthetic materials have issues with bone integration leading to implant failure. Here we introduce an artificial ligament that has the required mechanical properties and can integrate with the host bone and restore movement in animals. The ligament is assembled from aligned carbon nanotubes formed into hierarchical helical fibres bearing nanometre and micrometre channels. Osseointegration of the artificial ligament is observed in an anterior cruciate ligament replacement model where clinical polymer controls showed bone resorption. A higher pull-out force is found after a 13-week implantation in rabbit and ovine models, and animals can run and jump normally. The long-term safety of the artificial ligament is demonstrated, and the pathways involved in integration are studied.
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Affiliation(s)
- Liyuan Wang
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science and Laboratory of Advanced Materials, Fudan University, Shanghai, China
| | - Fang Wan
- Department of Orthopedic Sports Medicine, Huashan Hospital, The Sports Medicine Institute, Fudan University, Shanghai, China
| | - Yifan Xu
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science and Laboratory of Advanced Materials, Fudan University, Shanghai, China
| | - Songlin Xie
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science and Laboratory of Advanced Materials, Fudan University, Shanghai, China
| | - Tiancheng Zhao
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science and Laboratory of Advanced Materials, Fudan University, Shanghai, China
| | - Fan Zhang
- State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Institute of Biomedical Sciences, Human Phenome Institute, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Han Yang
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science and Laboratory of Advanced Materials, Fudan University, Shanghai, China
| | - Jiajun Zhu
- State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Institute of Biomedical Sciences, Human Phenome Institute, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jingming Gao
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science and Laboratory of Advanced Materials, Fudan University, Shanghai, China
| | - Xiang Shi
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science and Laboratory of Advanced Materials, Fudan University, Shanghai, China
| | - Chuang Wang
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science and Laboratory of Advanced Materials, Fudan University, Shanghai, China
| | - Linwei Lu
- Department of Integrative Medicine, Huashan Hospital, The Academy of Integrative Medicine, Fudan University, Shanghai, China
| | - Yifan Yang
- Department of Aeronautics and Astronautics, Fudan University, Shanghai, China
| | - Xiaoye Yu
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science and Laboratory of Advanced Materials, Fudan University, Shanghai, China
| | - Shiyi Chen
- Department of Orthopedic Sports Medicine, Huashan Hospital, The Sports Medicine Institute, Fudan University, Shanghai, China.
| | - Xuemei Sun
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science and Laboratory of Advanced Materials, Fudan University, Shanghai, China.
| | - Jiandong Ding
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science and Laboratory of Advanced Materials, Fudan University, Shanghai, China
| | - Peining Chen
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science and Laboratory of Advanced Materials, Fudan University, Shanghai, China.
| | - Chen Ding
- State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Institute of Biomedical Sciences, Human Phenome Institute, Zhongshan Hospital, Fudan University, Shanghai, China.
| | - Fan Xu
- Department of Aeronautics and Astronautics, Fudan University, Shanghai, China
| | - Hongbo Yu
- Vision Research Laboratory, School of Life Sciences, State Key Laboratory of Medical Neurobiology, Collaborative Innovation Centre for Brain Science, Fudan University, Shanghai, China
| | - Huisheng Peng
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science and Laboratory of Advanced Materials, Fudan University, Shanghai, China.
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Wang F, Sun P, Xie E, Ji Y, Niu Y, Li F, Wei J. Phytic acid/magnesium ion complex coating on PEEK fiber woven fabric as an artificial ligament with anti-fibrogenesis and osteogenesis for ligament-bone healing. BIOMATERIALS ADVANCES 2022; 140:213079. [PMID: 35985068 DOI: 10.1016/j.bioadv.2022.213079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 07/09/2022] [Accepted: 08/08/2022] [Indexed: 06/15/2023]
Abstract
Development of an artificial ligament possessing osteogenic activity to enhance ligament-bone healing for reconstruction of anterior cruciate ligament (ACL) is a great challenge. Herein, polyetheretherketone fibers (PKF) were coated with phytic acid (PA)/magnesium (Mg) ions complex (PKPM), which were woven into fabrics as an artificial ligament. The results demonstrated that PKPM with PA/Mg complex coating exhibited optimized surface properties with improved hydrophilicity and surface energy, and slow release of Mg ions. PKPM significantly enhanced responses of rat bone marrow stem cells in vitro. Moreover, PKPM remarkably promoted M2 macrophage polarization that upregulated production of anti-inflammatory cytokine while inhibited M1 macrophage polarization that downregulated production of pro-inflammatory cytokine in vitro. Further, PKPM inhibited fibrous encapsulation by preventing M1 macrophage polarization while promoted osteogenesis for ligament-bone healing by triggering M2 macrophage polarization in vivo. The results suggested that the downregulation of M1 macrophage polarization for inhibiting fibrogenesis and upregulation of M2 macrophage polarization for improving osteogenesis of PKPM were attributed to synergistic effects of PA and sustained release of Mg ions. In summary, PKPM with PA/Mg complex coating upregulated pro-osteogenic macrophage polarization that supplied a profitable anti-inflammatory environments for osteogenesis and ligament-bone healing, thereby possessing tremendous potential for reconstruction of ACL.
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Affiliation(s)
- Fan Wang
- Shanghai Key Laboratory of Advanced Polymeric Materials, Key Laboratory for Ultrafine Materials of Ministry of Education, School of Material Science and Engineering, East China University of Science and Technology, Shanghai 200237, China
| | - Ping Sun
- Department of Orthopaedics, Shanghai Eighth People's Hospital, Shanghai 200235, China
| | - En Xie
- Shanghai Key Laboratory of Advanced Polymeric Materials, Key Laboratory for Ultrafine Materials of Ministry of Education, School of Material Science and Engineering, East China University of Science and Technology, Shanghai 200237, China
| | - Yinjun Ji
- Department of Orthopaedics, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| | - Yunfei Niu
- Department of Orthopaedics, Changhai Hospital, Second Military Medical University, Shanghai 200433, China.
| | - Fengqian Li
- Department of Orthopaedics, Shanghai Eighth People's Hospital, Shanghai 200235, China.
| | - Jie Wei
- Shanghai Key Laboratory of Advanced Polymeric Materials, Key Laboratory for Ultrafine Materials of Ministry of Education, School of Material Science and Engineering, East China University of Science and Technology, Shanghai 200237, China.
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