In vitro fibroblast seeding of prosthetic anterior cruciate ligaments. A preliminary study

To evaluate the effect of in vitro seeding of fibroblasts on the connective tissue encapsulation of implanted ligament prostheses, canine skin fibroblasts were grown in tissue culture and seeded onto knitted Dacron prostheses. When the cells on the prostheses reached contact growth inhibition, as determined by growth curves, the prostheses were implanted into the dogs' knees as ACL replacements. Gross and histologic evaluation at 4 and 8 weeks revealed that the seeded prostheses consistently showed more uniform and abundant encapsulation with connective tissue than did the control (unseeded) prostheses. The giant cell response observed in the tissue surrounding the unseeded prostheses was not noted in the seeded prostheses. This may be because seeding a prosthesis with fibroblasts prior to implantation "walls off" the prosthesis from the environment of the joint, and therefore the prosthesis may not elicit as great a foreign body response as does an unseeded prosthesis. The results of this preliminary study suggest that the in vitro seeding of a ligament prosthesis with fibroblasts accelerates the connective tissue encapsulation of the implanted prosthesis.