Analysis of Time to Form Colony Units for Connective Tissue Progenitor Cells (Stem Cells) Harvested From Concentrated Bone Marrow Aspirate and Subacromial Bursa Tissue in Patients Undergoing Rotator Cuff Repair

Abstract

Purpose To evaluate the time required for colonies to develop from concentrated bone marrow aspirate (cBMA) and subacromial bursal tissue samples. Methods Samples of cBMA and subacromial bursa tissue were harvested from patients undergoing rotator cuff repair surgery between November 2014 and December 2019. Samples were analyzed for time to form colonies and number of colonies formed. The impact of age, sex, and cellularity (cBMA only) was analyzed. Samples were cultured and evaluated daily for colony formation in accordance with the guidelines of the International Society for Cellular Therapy. Demographic factors were analyzed for impact on time to form colonies and number of colonies formed. Results Samples of cBMA were obtained from 92 patients. Subacromial bursa tissue was obtained from 54 patients. For cBMA, older age was associated with more days to form colonies ( P = .003), but sex ( P = .955) and cellularity ( P = .623) were not. For bursa, increased age was associated with longer time to form colonies ( P = .002) but not sex ( P = .804). Conclusions : Increased age (in cBMA and subacromial bursa tissue) and lower initial cellularity (in cBMA) are associated with longer time to form colonies in culture. Clinical Relevance Although connective tissue progenitor cells are widely used in orthopaedic practice, there are few metrics to determine their efficacy. Time to form colonies may serve as an important measurement for determining connective tissue progenitor cell viability for augmentation of rotator cuff repair. Subacromial bursa tissue may represent a viable alternative to cBMA for augmentation of rotator cuff repair, capable of forming colonies expediently in vivo.

Trochanteric Bursa Is a Source of Connective Tissue Progenitor Cells

“…These cells showed similar in vitro behaviors as those derived from the subacromial bursa, with high cellular viability and proliferation, as well as excellent potentials for differentiation into osteogenic, adipogenic, and chondrogenic lineages. [2][3][4]23,24 We further observed no difference in the nucleated cell count, CTP cellular concentration, proliferation, and expression of CTPspecific surface markers in the bursal tissue collected over the tendon compared to over the muscle belly of the hip abductors. The biologic role of these cells is unknown but may parallel those of the subacromial bursa and the rotator cuff.…”

The Effect of Insulin and Insulin-like Growth Factor 1 (IGF-1) on Cellular Proliferation and Migration of Human Subacromial Bursa Tissue

“…During the patient’s arthroscopic rotator cuff repair, subacromial bursa from directly over the rotator cuff tendon (supraspinatus/infraspinatus) was harvested using an arthroscopic grasper device, ( Fig 1 A), placed into sterile 3-mL syringes, and measured for reference ( Fig 1 B). 10 , 11 , 16 , 17 , 18 The samples were immediately transported from the operating room to a laminar flow hood for processing. One 200-mg sample of each bursa specimen was carefully weighed for plating.…”

Arthroscopic Rotator Cuff Repair Augmented with Autologous Subacromial Bursa Tissue, Concentrated Bone Marrow Aspirate, Platelet-Rich Plasma, Platelet-Poor Plasma, and Bovine Thrombin

“… 6 , 7 , 8 In vitro characterizations of SBT have shown that these cells fulfill all characteristics of MSCs, including high proliferative potential, similar expression of surface markers, and multilineage differentiation. 6 , 8 , 9 , 10 , 11 , 12 , 13 , 14 Further, Morikawa et al. recently described a novel, effective, nonenzymatic method for mechanically isolating progenitor cells with MSC characteristics from SBT for clinical use.…”