Biomaterial Structures for Anterior Cruciate Ligament Replacement

The anterior cruciate ligament (ACL) significantly participates in the normal knee function and stability. It is attached to the tibia and femur and transmits the forces developed during motion. This chapter focuses on the recent advances in artificial ligament fabrication and surface modification utilized for the manufacturing of off the shelf implants. It elaborates on the promise of tissue engineering for ACL replacement. Polyethylene terephthalate (PET) artificial ligaments have attracted significant attention from the orthopedic community and recent advances in enhancing the performance of the ligament have focussed on the ligament biointegration. Ascorbic acid is utilized at various concentrations and in combination with fibroblasts' specific growth factors for favoring the deposition of the collagenous matrix, which enables creation of the cell sheet. Tissue engineering is evolving rapidly and is a promising technology whose application is nevertheless limited by the high cost associated with the in vitro maturation of the neo-tissue.