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The Development of a Xenograft-Derived Scaffold for Tendon and Ligament Reconstruction Using a Decellularization and Oxidation Protocol.

Publication ,  Journal Article
Seyler, TM; Bracey, DN; Plate, JF; Lively, MO; Mannava, S; Smith, TL; Saul, JM; Poehling, GG; Van Dyke, ME; Whitlock, PW
Published in: Arthroscopy
February 2017

PURPOSE: To evaluate the biological, immunological, and biomechanical properties of a scaffold derived by architectural modification of a fresh-frozen porcine patella tendon using a decellularization protocol that combines physical, chemical, and enzymatic modalities. METHODS: Porcine patellar tendons were processed using a decellularization and oxidation protocol that combines physical, chemical, and enzymatic modalities. Scaffolds (n = 88) were compared with native tendons (n = 70) using histologic, structural (scanning electron microscopy, porosimetry, and tensile testing), biochemical (mass spectrometry, peracetic acid reduction, DNA quantification, alpha-galactosidase [α-gal] content), as well as in vitro immunologic (cytocompatibility, cytokine induction) and in vivo immunologic nonhuman primate analyses. RESULTS: A decrease in cellularity based on histology and a significant decrease in DNA content were observed in the scaffolds compared with the native tendon (P < .001). Porosity and pore size were increased significantly (P < .001). Scaffolds were cytocompatible in vitro. There was no difference between native tendons and scaffolds when comparing ultimate tensile load, stiffness, and elastic modulus. The α-gal xenoantigen level was significantly lower in the decellularized scaffold group compared with fresh-frozen, nondecellularized tissue (P < .001). The in vivo immunological response to implanted scaffolds measured by tumor necrosis factor-α and interleukin-6 levels was significantly (P < .001) reduced compared with untreated controls in vitro. These results were confirmed by an attenuated response to scaffolds in vivo after implantation in a nonhuman primate model. CONCLUSIONS: Porcine tendon was processed via a method of decellularization and oxidation to produce a scaffold that possessed significantly less inflammatory potential than a native tendon, was biocompatible in vitro, of increased porosity, and with significantly reduced amounts of α-gal epitope while retaining tensile properties. CLINICAL RELEVANCE: Porcine-derived scaffolds may provide a readily available source of material for musculoskeletal reconstruction and repair while eliminating concerns regarding disease transmission and the morbidity of autologous harvest.

Duke Scholars

Published In

Arthroscopy

DOI

EISSN

1526-3231

Publication Date

February 2017

Volume

33

Issue

2

Start / End Page

374 / 386

Location

United States

Related Subject Headings

  • alpha-Galactosidase
  • Tissue Scaffolds
  • Tensile Strength
  • Tendons
  • Swine
  • Oxidation-Reduction
  • Orthopedics
  • Ligaments
  • Heterografts
  • Animals
 

Citation

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Seyler, T. M., Bracey, D. N., Plate, J. F., Lively, M. O., Mannava, S., Smith, T. L., … Whitlock, P. W. (2017). The Development of a Xenograft-Derived Scaffold for Tendon and Ligament Reconstruction Using a Decellularization and Oxidation Protocol. Arthroscopy, 33(2), 374–386. https://doi.org/10.1016/j.arthro.2016.07.016
Seyler, Thorsten M., Daniel N. Bracey, Johannes F. Plate, Mark O. Lively, Sandeep Mannava, Thomas L. Smith, Justin M. Saul, Gary G. Poehling, Mark E. Van Dyke, and Patrick W. Whitlock. “The Development of a Xenograft-Derived Scaffold for Tendon and Ligament Reconstruction Using a Decellularization and Oxidation Protocol.Arthroscopy 33, no. 2 (February 2017): 374–86. https://doi.org/10.1016/j.arthro.2016.07.016.
Seyler TM, Bracey DN, Plate JF, Lively MO, Mannava S, Smith TL, et al. The Development of a Xenograft-Derived Scaffold for Tendon and Ligament Reconstruction Using a Decellularization and Oxidation Protocol. Arthroscopy. 2017 Feb;33(2):374–86.
Seyler, Thorsten M., et al. “The Development of a Xenograft-Derived Scaffold for Tendon and Ligament Reconstruction Using a Decellularization and Oxidation Protocol.Arthroscopy, vol. 33, no. 2, Feb. 2017, pp. 374–86. Pubmed, doi:10.1016/j.arthro.2016.07.016.
Seyler TM, Bracey DN, Plate JF, Lively MO, Mannava S, Smith TL, Saul JM, Poehling GG, Van Dyke ME, Whitlock PW. The Development of a Xenograft-Derived Scaffold for Tendon and Ligament Reconstruction Using a Decellularization and Oxidation Protocol. Arthroscopy. 2017 Feb;33(2):374–386.
Journal cover image

Published In

Arthroscopy

DOI

EISSN

1526-3231

Publication Date

February 2017

Volume

33

Issue

2

Start / End Page

374 / 386

Location

United States

Related Subject Headings

  • alpha-Galactosidase
  • Tissue Scaffolds
  • Tensile Strength
  • Tendons
  • Swine
  • Oxidation-Reduction
  • Orthopedics
  • Ligaments
  • Heterografts
  • Animals