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The approach we have been focusing on for the last three years is the development of a substitute provisional scaffold that can stimulate the production of functional scar in the ACL.
Our initial study published in the Journal of Orthopaedic Research demonstrated the effectiveness of a collagen bridge in stimulating ACL cell migration into the gap between ligament fascicles in vitro (9). However, with the collagen scaffold (CS) alone, the ACL cell and tissue response was slow, and we began incorporating PRP into the CS as a source of growth factors and additional plasma proteins. Our rationale for this was that the provisional scaffold in other tissues is blood clot (which is made of PRP plus red blood cells). Thus, we reasoned that ACL healing might also be stimulated by the growth factors and extracellular matrix proteins found in platelet-rich-plasma.
We have developed in vitro assays to test the ability of ACL cells to migrate through various candidate scaffolds, as well as to proliferate and produce collagen, and have optimized the scaffold in vitro.
Our more recent work, performed in collaboration with Dr Kurt Spindler at Vanderbilt University Medical Center, has focused on the in vivo delivery of platelet-rich plasma/collagen scaffold composites to the injury site. An in vivo pilot study combined with our in vitro data, provide support for our hypothesis that it is the deficiency in provisional scaffold formation that prevents healing in the intra-articular environment.
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