Authors: Keagan Riser, Vincent S. Gallicchio.
This paper will detail the current research pertaining to stem cell use in anterior cruciate ligament repair. Stem cells have expanded treatment options to include injection of stem cells into allograft ligament, and bioengineered scaffolding. There are numerous types of stem cells that can be used in these procedures, but the most common type used is bone marrow mesenchymal stem cells (BM-MSCs), because of their ability to differentiate into chondrocytes, adipocytes, and hematopoietic cells, all necessary products in the ligament healing process. Issues with the injection method include number of viable cells in the cell count, the correct angle and location of injection, and binding of the BM-MSCs to appropriate target once in vivo. The scaffolding method can involve a few treatment options: three-dimensional printing of a bioengineered scaffold that is afterwards coated in BM-MSCs, allograft scaffold that is laced with BM-MSCs and inserted during the surgery, or decellularized allografts that BM-MSCs have been added to. Many of the same issues arise in this method, such as viable stem cell count, but with the scaffolding there is more success of correct location placement and stem cell differentiation in vivo. In both of these methods it is also important to discuss the appropriate growth factors that must be important for differentiation of the targeted stem cell. Overall, the allograft scaffold laced with BM-MSCs shows to be the most effective repair method, and direct injection appears to aid in the healing of the autograft and promotes exponential differentiation of the laced stem cells.
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