Archives of Orthopaedic and Trauma Surgery

, Volume 127, Issue 9, pp 815–821

Tissue engineering of tendons and ligaments by human bone marrow stromal cells in a liquid fibrin matrix in immunodeficient rats: Results of a histologic study


    • Trauma DepartmentHanover Medical School (MHH)
  • Martijn van Griensven
    • Ludwig Boltzmann InstituteResearch Centre for Traumatology
  • Marco Ezechieli
    • Trauma DepartmentHanover Medical School (MHH)
  • Tanja Barkhausen
    • Trauma DepartmentHanover Medical School (MHH)
  • Matthew Austin
    • Rothman InstituteOrthopaedic Surgery
  • Michael Jagodzinski
    • Trauma DepartmentHanover Medical School (MHH)
  • Rupert Meller
    • Trauma DepartmentHanover Medical School (MHH)
  • Ulrich Bosch
    • Orthopaedic DepartmentInternational Neuroscience Institute
  • Christian Krettek
    • Trauma DepartmentHanover Medical School (MHH)
  • Johannes Zeichen
    • Trauma DepartmentHanover Medical School (MHH)
Arthroscopy and Sports Medicine

DOI: 10.1007/s00402-007-0366-z

Cite this article as:
Hankemeier, S., van Griensven, M., Ezechieli, M. et al. Arch Orthop Trauma Surg (2007) 127: 815. doi:10.1007/s00402-007-0366-z



The original complex structure and mechanical properties are not fully restored after ligament and tendon injuries. Due to their high proliferation rate and differentiation potential, Bone Marrow Stromal Cells (BMSC) are considered to be an ideal cell source for tissue engineering to optimize the healing process. Ideal matrices for tissue engineering of ligaments and tendons should allow for homogenous cell seeding and offer sufficient stability.

Material and methods

A mixture of human BMSC and liquid fibrin glue was injected into a standardized full-thickness window defect of the patellar tendon of immunodeficient rats (BMSC group). The histology of the tissue was analysed 10 and 20 days postoperatively and compared to four control groups. These groups consisted of a cohort with a mixture of human fibroblasts and fibrin glue, fibrin glue without cells, a defect group without treatment, and a group with uninjured patellar tendon tissue.


Tendon defects in the BMSC group revealed dense collagen fibres and spindle-shaped cells, which were mainly orientated along the loading axis. Histologic sections of the control groups, especially of untreated defects and of defects filled with fibrin glue only, showed irregular patterns of cell distribution, irregular formed cell nucleoli and less tissue maturation. Compared to healthy tendon tissue, higher numbers of cells and less intense matrix staining was observed in the BMSC group. No ectopic bone or cartilage formation was observed in any specimen.


Injection of human BMSC in a fibrin glue matrix appears to lead to more mature tissue formation with more regular patterns of cell distribution. Advantages of this “in-vivo” tissue engineering approach are a homogenous cell-matrix mixture in a well-known and approved biological matrix, and simple, minimally-invasive application by injection.


BMSCTissue engineeringTendonLigamentFibrin glueHistologyHealing

Copyright information

© Springer-Verlag 2007