Anterior Cruciate Ligament Tissue Engineering: Biological Principles, Engineered Substitutes, and Preclinical...

Area of Science:

• Orthopedics
• Biomedical Engineering
• Regenerative Medicine

Background:

• Increasing incidence of anterior cruciate ligament (ACL) injuries, especially in young athletes, necessitates improved treatment options.
• Current ACL reconstruction using autografts has limitations including donor-site morbidity and inconsistent long-term joint stability, potentially leading to osteoarthritis.
• Tissue engineering (TE) presents a promising alternative for biological ACL substitutes, but clinical validation for functional regeneration is still pending.

Purpose of the Study:

• To provide a comprehensive review of current tissue engineering (TE) strategies for ACL repair and reconstruction.
• To analyze the biological and biomechanical limitations of existing TE approaches for ACL regeneration.
• To discuss emerging concepts and future perspectives, including the role of artificial intelligence (AI), for enhanced ACL clinical outcomes.

Main Methods:

• Review of current literature on tissue engineering (TE) approaches for ACL regeneration.
• Analysis of biological and biomechanical principles and limitations of TE strategies.
• Exploration of emerging concepts and the integration of artificial intelligence (AI) in ACL reconstruction.

Main Results:

• Tissue engineering (TE) has shown potential for ACL regeneration, but no strategy has yet achieved reliable, clinically validated functional regeneration.
• Current TE approaches face challenges in replicating the native ACL's complex biological and biomechanical properties.
• Artificial intelligence (AI) is emerging as a valuable tool for improving diagnosis, surgical planning, and personalized ACL reconstruction.

Conclusions:

• Tissue engineering (TE) holds significant promise for overcoming the limitations of current ACL reconstruction methods.
• Further research and development are crucial to achieve clinically validated functional regeneration of the ACL.
• The integration of AI with TE strategies may offer novel and personalized solutions for ACL repair and reconstruction, improving long-term joint health.