J Wrist Surg 2021; 10(06): 492-501
DOI: 10.1055/s-0041-1729993
Special Review: The Scapholunate Dilemma

Additive Manufacturing: The Next Generation of Scapholunate Ligament Reconstruction

Matthew N. Rush
1   Department of Orthopaedics and Rehabilitation, The University of New Mexico Health Sciences Center, Albuquerque, New Mexico
,
1   Department of Orthopaedics and Rehabilitation, The University of New Mexico Health Sciences Center, Albuquerque, New Mexico
2   Center for Biomedical Engineering, The University of New Mexico, Albuquerque, New Mexico
3   Department of Mechanical Engineering, The University of New Mexico, Albuquerque, New Mexico
,
Lorraine Mottishaw
1   Department of Orthopaedics and Rehabilitation, The University of New Mexico Health Sciences Center, Albuquerque, New Mexico
2   Center for Biomedical Engineering, The University of New Mexico, Albuquerque, New Mexico
,
Damian Fountain
1   Department of Orthopaedics and Rehabilitation, The University of New Mexico Health Sciences Center, Albuquerque, New Mexico
4   Department of Biochemistry and Molecular Biology, The University of New Mexico, Albuquerque, New Mexico
,
1   Department of Orthopaedics and Rehabilitation, The University of New Mexico Health Sciences Center, Albuquerque, New Mexico
› Institutsangaben
Funding This research was supported in part by the NIH through a Research Supplement to Promote Diversity in Health-Related Research (UL1TR001449) as well as the American Foundation for Surgery of the Hand, Basic Science Research Grant (2016–2018), both awarded to C.S.

Abstract

Background Ligament reconstruction, as a surgical method used to stabilize joints, requires significant strength and tissue anchoring to restore function. Historically, reconstructive materials have been fraught with problems from an inability to withstand normal physiological loads to difficulties in fabricating the complex organization structure of native tissue at the ligament-to-bone interface. In combination, these factors have prevented the successful realization of nonautograft reconstruction.

Methods A review of recent improvements in additive manufacturing techniques and biomaterials highlight possible options for ligament replacement.

Description of Technique In combination, three dimensional-printing and electrospinning have begun to provide for nonautograft options that can meet the physiological load and architectures of native tissues; however, a combination of manufacturing methods is needed to allow for bone-ligament enthesis. Hybrid biofabrication of bone-ligament tissue scaffolds, through the simultaneous deposition of disparate materials, offer significant advantages over fused manufacturing methods which lack efficient integration between bone and ligament materials.

Results In this review, we discuss the important chemical and biological properties of ligament enthesis and describe recent advancements in additive manufacturing to meet mechanical and biological requirements for a successful bone–ligament–bone interface.

Conclusions With continued advancement of additive manufacturing technologies and improved biomaterial properties, tissue engineered bone-ligament scaffolds may soon enter the clinical realm.



Publikationsverlauf

Eingereicht: 22. Oktober 2020

Angenommen: 06. April 2021

Artikel online veröffentlicht:
21. Juni 2021

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