Verdiyeva, Gunay; (2020) Biomimicry of Human Tendons with 3D Printed Tendon Scaffolds for Tendon Reconstruction. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

Musculoskeletal injuries are very common among the population and a substantial proportion of the trauma related or overuse injuries involve tendons. Despite available surgical management strategies, there is still growing need for new reconstruction methods for repair of injured tendons. In this project we hypothesise tissue engineering using 3D printed biomimetic, bespoke tendon scaffolds as potential management for tendon repair. A wide number of experiments were conducted for design, modelling and optimisation of printed constructs. Scaffolds made with various types of thermoplastic polyurethanes are investigated for a range of mechanical properties to detect the adequacy of their functional biomimicry. These studies were further expanded to investigate the effect of scaffold density and pattern on mechanical properties of the scaffolds. This was followed by studies to design tendon insertion sites and integration of designed scaffolds to bones. In vitro studies were also performed to explore biocompatibility of 3D printed grafts. Scaffolds with different topographical properties and cell response to scaffold microstructure were studied to determine the most optimal scaffold types for tendon reconstruction. Results of the studies demonstrated good tensile, compression and fatigue properties of polymer scaffolds. Comparison of scaffolds printed with different materials showed that TPU scaffolds produced superior results. These scaffolds were proven to be the most suitable for printing of the grafts and have good static and dynamic mechanical properties. The results of topography studies showed significant difference in physical properties of printed scaffolds with concentric patterned scaffolds being the most optimal for tendon tissue engineering applications. Biocompatibility of these scaffolds was confirmed with cell culture experiments performed with human fibroblasts. Cell response to topographical features demonstrated some interesting results, with concentric scaffolds with 40% density being the most ideal for the application. Bespoke scaffold modelling and enthesis design was successfully utilised to further optimise the printed grafts. In conclusion, tissue engineering of tendons using 3D printed TPU scaffolds is a promising method to overcome potential disadvantages of currently available suturing and graft techniques and in addition, has many benefits over existing scaffold design methods.

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