Preliminary study of an in vitro development of new tissue applying mechanical stimulation with a bioreactor as an alternative for ligament reconstruction

Complete rupture of the anterior cruciate ligament (ACL) is a common problem in orthopedics. At present, there are many techniques to reconstruct ligaments, which include the use of autografts, allografts, and, in some cases, artificial ligaments. The latter have not provided good results in the short, medium, and long term. The purpose of present study was to engineer functional biological tissue that could potentially be used to replace the knee ligaments by applying tissue engineering techniques and mechanical stimulation with a bioreactor, promoting cellular differentiation and matrix synthesis. In this preliminary study, the new tissue was characterized with mechanical tests and biological tests (viability and immunochemistry), comparing their behavior with that of the native tissue. Mechanical and biological tests proved that mechanical stimulation administered with a bioreactor maintains the ligament fibroblast phenotype and promotes synthesis of the extracellular matrix.