Identifying the optimum source of mesenchymal stem cells for use in knee surgery

Abstract

Single sitting procedures where the mononuclear cell fraction is extracted from bone marrow and implanted directly into cartilage and bone defects are becoming more popular as novel treatments for cartilage defects which have, until now had few treatment options. This is on the basis that the mesenchymal stem cells (MSCs) contained within will repair the damaged tissue. This study sought to determine if the femur and tibia could provide equivalent amounts of mesenchymal stem cells, with equivalent viability and proliferative capacity, to that obtained from the gold standard of the pelvis in order to potentially reduce the morbidity associated with these procedures. Bone marrow was extracted from the pelvis, femur, and tibia of human subjects. The mononuclear cell fraction was extracted and cultured in the laboratory. Mesenchymal stem cell populations were assessed using a colony forming unit count. Viability was assessed using a PrestoBlue viability assay. Population doubling number was calculated between the end of passage 0 and passage three to determine the proliferative abilities of the different populations. Finally, the cell surface phenotype of the cells was determined by flow cytometry. The results showed that the pelvis was superior to the femur and tibia in terms of the number of stem cells isolated. There was no statistically significant difference in the phenotype of the cells isolated from different locations. This work shows that when undertaking single sitting procedures, the pelvis remains the optimum source for obtaining MSCs, despite the morbidity associated with bone marrow collection from the pelvis. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1868-1875, 2017.

Management of osteoarthritis - biological approaches: current concepts

“…Commonly used sites include the iliac crest, distal femur, proximal tibia, proximal humerus and the calcaneus. Authors have reported that bone marrow aspirate taken from the posterior iliac crest has the highest concentration of BM-MSCs 46–49. There are at least eight commercially available systems that can be used to harvest bone marrow aspirate, all of which require 30 mL at a minimum, but preferably 60 mL 22.…”

Reduced neuroprotective potential of the mesenchymal stromal cell secretome with ex vivo expansion, age and progressive multiple sclerosis

“…Aside from age-mismatch between cohorts, an additional potential limitation of our study is difference in MSC origin between patients with MS and control subjects. Notably, however, pelvic marrow is generally accepted as the gold standard for isolation of MSCs [43] . That the control cohort had osteoarthritis could be a possible additional confounding effect, although, aside from age-related effects, there have been no consistent reports of the effects of osteoarthritis on isolation and proliferation of MSCs from femoral shaft marrow [44] , [45] , [46] , [47] .…”

Regenerative Medicine for Axial and Radicular Spine‐Related Pain: A Narrative Review

“…Bone marrow aspirate concentrate is the term used to describe the MSCs and marrow elements obtained from bone marrow aspiration. The posterior iliac crest is most commonly used, since it has been shown to provide the highest concentration of MSCs . The aspirate must undergo density gradient centrifugation to isolate progenitor cells because they account for a small population of the cells within bone marrow (0.001% to 0.01%) .…”

“…The posterior iliac crest is most commonly used, since it has been shown to provide the highest concentration of MSCs. 32 The aspirate must undergo density gradient centrifugation to isolate progenitor cells because they account for a small population of the cells within bone marrow (0.001% to 0.01%). 33 BMAC has been shown to serve as a source for growth factors such as platelet-derived growth factor, TGF-b, and bone morphogenetic protein 2, which have anabolic and anti-inflammatory effects.…”