Ceramic Scaffolds in a Vacuum Suction Handle for Intraoperative Stromal Cell Enrichment

Abstract

During total joint replacement, high concentrations of mesenchymal stromal cells (MSCs) are released at the implantation site. They can be found in cell–tissue composites (CTC) that are regularly removed by surgical suction. A surgical vacuum suction handle was filled with bone substitute granules, acting as a filter allowing us to harvest CTC. The purpose of this study was to investigate the osteopromotive potential of CTC trapped in the bone substitute filter material during surgical suction. In the course of 10 elective total hip and knee replacement surgeries, β-tricalcium-phosphate (TCP) and cancellous allograft (Allo) were enriched with CTC by vacuum suction. Mononuclear cells (MNC) were isolated from the CTC and investigated towards cell proliferation and colony forming unit (CFU) formation. Furthermore, MSC surface markers, trilineage differentiation potential and the presence of defined cytokines were examined. Comparable amounts of MNC and CFUs were detected in both CTCs and characterized as MSC‰ of MNC with 9.8 ± 10.7‰ for the TCP and 12.8 ± 10.2‰ for the Allo (p = 0.550). CTCs in both filter materials contain cytokines for stimulation of cell proliferation and differentiation (EGF, PDGF-AA, angiogenin, osteopontin). CTC trapped in synthetic (TCP) and natural (Allo) bone substitute filters during surgical suction in the course of a joint replacement procedure include relevant numbers of MSCs and cytokines qualified for bone regeneration.

Surgical Site-Released Tissue Is Potent to Generate Bone onto TCP and PCL-TCP Scaffolds In Vitro

“…Since the ability to adhere onto plastic surfaces is a criterion for mesenchymal stroma cells-the progenitors of osteoblasts-the PMMA filter of the harvesting device may also have a potential to increase the number of MSCs, and thus, promote osteoblast differentiation. As published previously, the cells isolated from SSRT have shown great osteopromotion in vitro [5,53]. This hypothesis is also supported by Groven et al who used the same tissue collector device (BoneFlo ® ) and showed exclusively expressed osteogenic miRNAs as well as overall enhanced osteogenic marker gene expression in SSRT [54].…”

Intraoperative Creation of Tissue-Engineered Grafts with Minimally Manipulated Cells: New Concept of Bone Tissue Engineering In Situ

“…Henze et al (2019) demonstrated that the surgical suction filter can accumulate MSCs during joint replacement surgery [ 72 ]. In the study by Busch et al (2020) porous bone substitute material was placed in the suction device, and the accumulation of mononuclear cells (MNCs), including MSCs, epidermal growth factor, platelet-derived growth factor, and other cytokines in bone substitute material was confirmed [ 73 ].…”

Functionalization of Synthetic Bone Substitutes

“…The cytochemical staining demonstrated high osteogenity of the cell-tissue composite (CTC). In total, 104 human cytokines, chemokines, growth factors, hormones and other soluble proteins were detected in the cell tissue composite from the surgical vacuum filter [ 102 ].…”