Development of fibroblast-seeded ligament analogs for ACL reconstruction.

We fabricated "ligament analogs" in vitro by seeding high-strength resorbable collagen fiber scaffolds with intraarticular (anterior cruciate ligament, ACL) or extraarticular (patellar tendon, PT) rabbit fibroblasts. Fibroblasts attached, proliferated, and secreted new collagen on the ligament analogs in vitro. Fibroblast function depended on the tissue culture substrate (ligament analog vs. tissue culture plate) and the origin of the fibroblasts (ACL vs. PT) PT fibroblasts proliferated more rapidly than ACL fibroblasts when cultured on ligament analogs. Collagen synthesis by ACL and PT fibroblasts was approximately tenfold greater on ligament analogs than on tissue culture plates. The composition, structure, and geometry of the collagen fiber scaffolds may promote collagen synthesis within ligament analogs in vitro. Ligament analogs roughly approximate the structure and strength of native ligament tissue. Ongoing in vivo studies suggest that autogenous fibroblast-seeded ligament analogs remain viable after implantation into the knee joint. With further development, ligament analogs may be useful as implants for ACL reconstruction surgery.