Anterior Cruciate Ligament Tissue Engineering: Biological Principles, Engineered Substitutes, and Preclinical Outcomes

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

The rising popularity of sports practiced without adequate preparation has increased the incidence of anterior cruciate ligament (ACL) injuries, particularly among young individuals. Because the ACL has a very limited intrinsic healing capacity, surgical reconstruction-most often using autologous grafts-remains the standard of care. However, current techniques frequently lead to donor-site morbidity and do not consistently restore long-term joint stability, contributing to early post-traumatic osteoarthritis in active patients. Over the past decades, tissue engineering (TE) has opened promising avenues for developing biological substitutes capable of overcoming these limitations. Despite substantial progress, no strategy has yet demonstrated reliable and clinically validated functional regeneration of the human ACL. Meanwhile, artificial intelligence is emerging as a complementary tool for diagnosis, surgical planning, biomechanical assessment, and personalized reconstruction strategies. This review aims to provide a comprehensive overview of current TE-based approaches for ACL repair and reconstruction, analyzes their biological and biomechanical limitations, and discusses emerging concepts that may enhance future clinical outcomes. We first summarize the fundamental principles of tissue engineering, then examine the major strategies proposed for ACL regeneration-highlighting

Evidence level

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

Browse all related research

Filter the research library by this study's title keywords, author, or publication year.