ANTERIOR CRUCIATE LIGAMENT TISSUE ENGINEERING: A REVIEW OF CURRENT INVESTIGATIONS

The anterior cruciate ligament (ACL) is the most commonly injured ligament of the knee. The incidence of rupture is reported to be 1/3000, and approximately 100,000 reconstructive surgeries are performed annually in the United States. Reconstruction of the anterior cruciate ligament aims to restore mechanical stability to the knee joint and impede formation of osteoarthritis and other degenerative joint issues. Due to the limitations in long term stability and comorbidities associated with current available graft options, the possibility of utilizing tissue engineering to aid in the healing of the anterior cruciate ligament has gained significant attention. The goal of tissue engineering is to develop a degradable scaffold that provides sufficient initial strength and stability to the knee joint to support normal functioning post-implantation, while allowing cells and growth factor infiltration for remodeling and eventual restoration of the ACL. The investigation into the possibility of a tissue engineered ACL graft is still in its early stages. The search for an ideal scaffold construct and cell source continues to be a challenge. However, earlier studies show promise and future investigations are sure to bring us closer to in vivo implementation and utilization of an appropriately engineered ACL graft with the structural integrity comparable to the native ACL.