Objective: To find out the feasibility of tendon engineering in vitro using expanded tenocytes and polyglycolic acids (PGA).
Methods: Tenocytes were isolated using tissue explant method and expanded in vitro. Tenocytes (20 x 10(6)) at the second passage were collected and then seeded onto PGA unwoven fibers to form a cell-scaffold construct in a shape of tendon. The constructs were cultured in DMEM with 20% FBS for 1 week. The cell-scaffold constructs were then cultured under constant tension generated by a U-shaped spring (n = 5), which served as experimental group, or cultured without tension (n = 4), which served as control group 1. PGA fibers alone were cultured (n = 3), which served as control group 2. Small fragments at the end of the constructs were harvested at 2, 4 and 6 weeks respectively for histological and immunohistochemistry (IHC) analysis. Six-week samples were also evaluated by transmission electron microscope (TEM) and mechanical test.
Results: No obvious difference was observed among the three groups at 2 weeks grossly and histologically as the constructs remained to be mainly undegraded PGA fibers. By 4 weeks, a neo-tendon was formed in the experimental group and control group 1 grossly, and histology and IHC revealed the formation of collagen fibers. In contrast, PGA fibers alone in control group 2 were mostly degraded. At 6 weeks, tendons of control group 1 were much thicker [(2.55 +/- 0.18) mm in diameter] than those of experimental group [(1.44 +/- 0.13) mm in diameter]. Periodical striae were observed in collagen fibers of experimental group and control group 1 by TEM. However, histology of tendons in experimental group revealed longitudinally aliened collagen fibers, which resembled the structure of normal tendon more closely than that of control group 1 tendons. Furthermore, the maximum tensile stress (N/mm(2)) of experimental group (1.107 +/- 0.327) was greater than that of control group 1 (0.294 +/- 0.138) (P < 0.05).
Conclusion: It is possible to use an engineering to construct tendon tissue in vitro. Periodical strain generated by bioreactor may be the optimal mechanical stimulation, which is currently under investigation.
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