Intraoperative and In Vitro Classification of Subacromial Bursal Tissue

Baldino, Joshua B.; Muench, Lukas N.; Kia, Cameron; Johnson, Jeremiah N.; Morikawa, Daichi; Tamburini, Lisa M.; Landry, Arthur B.; Gordon-Hackshaw, Lemuel; Bellas, Nicholas; McCarthy, Mary Beth; Cote, Mark P.; Mazzocca, Augustus D.

doi:10.1016/j.arthro.2020.03.039

Cited by 21 publications

(35 citation statements)

References 31 publications

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“…[10][11][12] Along with these biologic adjuvants, subacromial bursal tissue, which is often discarded during arthroscopic surgery to ensure visualization of the rotator cuff tear, may also be a significant source of MSCs. [13][14][15][16] In vitro characterization of subacromial bursa-derived cells (SBDCs) has shown that these cells fulfill all characteristics of MSCs, including their proliferation potential, similar expression of surface antigen profiles, and multilineage differentiation. 13,15,17 Besides, SBDCs have been found to have superior engraftment to host tendon along with survival as well as greater proliferation and differentiation potentials when compared with concentrated bone marrow aspirate (cBMA).…”

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confidence: 99%

Preliminary Clinical Outcomes Following Biologic Augmentation of Arthroscopic Rotator Cuff Repair Using Subacromial Bursa, Concentrated Bone Marrow Aspirate, and Platelet-Rich Plasma

Muench

Kia

Berthold

et al. 2020

Arthroscopy, Sports Medicine, and Rehabilitation

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Purpose: To evaluate the clinical outcomes of patients who underwent arthroscopic rotator cuff repair augmented using subacromial bursa, concentrated bone marrow aspirate (cBMA), and platelet-rich plasma. Methods: Sixteen patients were included in the study who underwent arthroscopic rotator cuff repair augmented using subacromial bursa, cBMA, and platelet-rich plasma from January 2018 to July 2018 and had a minimum 1-year follow-up. American Shoulder and Elbow Surgeons (ASES), Simple Shoulder Test, Constant-Murley, and Single Assessment Numerical Evaluation (SANE) scores were collected preoperatively and at terminal follow-up. To determine the clinical relevance of ASES scores, the minimal clinically important difference, substantial clinical benefit, and the patient acceptable symptomatic state thresholds were used. In vitro cellular proliferation of subacromial bursa (nucleated cells/gram) and cBMA (nucleated cells and colony-forming units/cc) samples was evaluated and correlated to clinical outcomes scores. Results: Mean follow-up was 12.6 AE 1.8 months (range 12-19 months). Patients achieved significant improvement in ASES (45.8AE22.5 pre vs 88.5 AE 14.6 post, D44.7

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confidence: 99%

Preliminary Clinical Outcomes Following Biologic Augmentation of Arthroscopic Rotator Cuff Repair Using Subacromial Bursa, Concentrated Bone Marrow Aspirate, and Platelet-Rich Plasma

Muench

Kia

Berthold

et al. 2020

Arthroscopy, Sports Medicine, and Rehabilitation

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“…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.…”

Section: Methodsmentioning

confidence: 99%

“… 1 , 2 , 3 , 4 Recent in vitro characterizations of human subacromial bursa tissue (SBT) have shown that these cells fulfill the characteristics of mesenchymal stem cells (MSCs), including similar surface antigen expression profiles and multilineage differentiation, along with superior proliferation potential compared with other tissues within the shoulder, suggesting its use as an easily accessible, inexpensive, and viable augment for arthroscopic rotator cuff repair. 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 …”

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

Muench

Tamburini

Kriscenski

et al. 2021

Arthroscopy, Sports Medicine, and Rehabilitation

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Purpose To evaluate the effect of a one-time dose of insulin or insulin-like growth factor 1 (IGF-1) on cellular proliferation and migration of subacromial bursa tissue (SBT) over time. Methods SBT was harvested from over the rotator cuff tendon in 4 consecutive patients undergoing primary arthroscopic rotator cuff repair. SBT was cultured for 3 weeks in complete media until reaching confluence. The culture dishes were stored in a humidified, low oxygen tension (5% CO 2 ) incubator at 37°C. SBT of each patient underwent treatment with a one-time dose of insulin or IGF-1, whereas nontreated SBT served as a negative control. Cellular proliferation and migration were evaluated after 24, 48, 72, and 96 hours of incubation. SBT-derived cells migrated in the detection field were visualized using fluorescent microscopy. Results Cellular proliferation at 24, 48, 72, and 96 hours was 1.40 ± 0.27, 1.00 ± 0.20, 1.47 ± 0.31, and 1.68 ± 0.28 for IGF-1; 1.44 ± 0.24, 1.15 ± 0.27, 1.60 ± 0.36, and 1.61 ± 0.32 for insulin; and 1.51 ± 0.35, 1.29 ± 0.33, 1.53 ± 0.35, and 1.57 ± 0.38 for nontreated SBT. Untreated SBT demonstrated a significantly greater proliferation when compared with IGF-1 and insulin within the first 48 hours, although this effect was found to subside by 96 hours. Cellular migration at 24, 48, 72, and 96 hours was 575.7 ± 45.0, 641.6 ± 77.7, 728.3 ± 122.9, and 752.3 ± 114.5 for IGF-1; 528.4 ± 31.3, 592.5 ± 69.8, 664.2 ± 115.2, and 695.6 ± 148.2 for insulin; and 524.4 ± 41.9, 564.4 ± 49.8, 653.2 ± 81.5, and 685.7 ± 115.5 for nontreated SBT. Insulin showed no difference in migration at each timepoint compared to nontreated SBT ( P > .05, respectively). Conclusions Insulin and IGF-1 initially inhibit cellular proliferation of human SBT, although this effect was found to subside by 96 hours. Further, neither insulin nor IGF-1 changed the slope of cellular migration over time. However, each treatment group demonstrated a significant increase in cellular proliferation and migration. Clinical Relevance In the setting of biologic augmentation of rotator cuff repair, the compatibility and synergistic effect of insulin on human SBT is highly limited.

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“…The high rates of retear after rotator cuff repair are a significant concern, for which better solutions, such as augmentation with MSC, are being sought. For their report in this issue, "Intraoperative and In Vitro Classification of Subacromial Bursal Tissue," 1 Baldino, Muench, Kia, Johnson, Morikawa, Tamburini, Landry, Gordon-Hackshaw, Bellas, McCarthy, Cote, and Mazzocca are to be commended for an interesting and inspired investigation on the characterization of MSCs from the subacromial bursa of the shoulder as a potential source to augment healing and solution to this problem.…”

Section: See Related Article On Page 2057mentioning

confidence: 99%

Editorial Commentary: Mesenchymal Stem Cells in the Shoulder Subacromial Bursa: Do Cells Understand Statistical Significance?

Weiss¹

2020

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Intraoperative and In Vitro Classification of Subacromial Bursal Tissue

Cited by 21 publications

References 31 publications

Preliminary Clinical Outcomes Following Biologic Augmentation of Arthroscopic Rotator Cuff Repair Using Subacromial Bursa, Concentrated Bone Marrow Aspirate, and Platelet-Rich Plasma

Preliminary Clinical Outcomes Following Biologic Augmentation of Arthroscopic Rotator Cuff Repair Using Subacromial Bursa, Concentrated Bone Marrow Aspirate, and Platelet-Rich Plasma

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

Editorial Commentary: Mesenchymal Stem Cells in the Shoulder Subacromial Bursa: Do Cells Understand Statistical Significance?

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