Archive | 2021
VEGF functionalization of suture tape results in decreased graft inflammatory and catabolic response in a rabbit model of ACL reconstruction
Abstract
Abstract Introduction Improving ligament reconstruction biology may potentially be achieved through capturing autologous circulating factors such as vascular endothelial growth factor (VEGF) using commercially available biomaterials. Objectives To evaluate anterior cruciate ligament reconstruction (ACLR) using a VEGF functionalized suture tape in a rabbit model of ACLR with a semitendinosus autograft. Methods VEGF-binding peptides were covalently bonded to polyethylene suture tape (ST) to generate functionalized constructs. 46 female New Zealand white rabbit ACLs were reconstructed with semitendinosus hamstring autograft (n=6), hamstring\u202f+\u202fST (n=16), hamstring\u202f+\u202fscrambled peptide ST (n=17), and hamstring\u202f+\u202fVEGF-functionalized ST (n=17). Healing was evaluated at 2–4 weeks using PCR, RNA sequencing, micro CT, histology, and biomechanical testing. Results All rabbits successfully underwent ACLR, with no adverse events. ACLR with VEGF ST demonstrated significant decreases in inflammatory response (CD14, CD163), catabolism (MMP1, MMP3), and apoptosis (TNFSF10, Caspase-10) markers as compared to non-functionalized ST (p≤0.04). µCT demonstrated similar bone tunnel mineral density in hamstring\u202f+\u202fVEGF ST rabbits as compared to hamstring\u202f+\u202fscrambled ST controls (p≥0.31). Histology and biomechanical testing similarly demonstrated no adverse effects of VEGF-based immunomodulation on the tendon grafts. Conclusions Using a rabbit model, ACLR performed with VEGF-functionalized suture tape demonstrated significantly decreased markers of inflammation, catabolism, and apoptosis as compared to ACLR with non-functionalized suture tape. No adverse effects of functionalization were noted. Future studies should further investigate the utility of functionalized suture tape in ACLR.