The Influence of Trocar Fenestration and Volume on Connective Tissue Progenitor Cells (Stem Cells) in Arthroscopic Bone Marrow Aspiration From the Proximal Humerus

Voß, Andreas; McCarthy, Mary Beth; Singh, Hardeep; Beitzel, Knut; DiVenere, Jessica; Cote, Mark P.; Hoberman, Alexander; Nowak, Michael; Imhoff, Andreas B.; Mazzocca, Augustus D.

doi:10.1016/j.arthro.2016.12.013

Cited by 12 publications

(12 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…06–577-2). Nine of the 29 patients included in this study were also enrolled in the study by Voss et al comparing trocar fenestration [12]. All nine of these patients underwent non-fenestrated trocar aspiration [12].…”

Section: Methodsmentioning

confidence: 99%

“…Nine of the 29 patients included in this study were also enrolled in the study by Voss et al comparing trocar fenestration [12]. All nine of these patients underwent non-fenestrated trocar aspiration [12]. Patients were eligible for inclusion if they were 18 years or older and were indicated for primary arthroscopic rotator cuff repair after failing conservative treatment.…”

Section: Methodsmentioning

confidence: 99%

“…This technique allows the harvest site to later be used for placement of the medial anchor during rotator cuff surgery, thus decreasing donor site morbidity [4]. Using this method, a previous study by Voss et al found that CTPs could be present even after 40 ml of bone marrow aspiration from the same harvest site [12]. However, their study was limited in its focus on aspiration technique, and did not evaluate patient factors or the sequential decrease in CFUs with each aliquot obtained [12].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The effect of a single consecutive volume aspiration on concentrated bone marrow from the proximal humerus for clinical application

Muench¹,

Kia

Otto

et al. 2019

BMC Musculoskelet Disord

Self Cite

View full text Add to dashboard Cite

BackgroundLow aspiration volumes have been recommended to allow for higher concentrations of progenitor cells during bone marrow harvesting. However, these guidelines then require multiple aspiration attempts in order to maximize cellular yield. The purpose of this study was to investigate the effect of a single, high-volume aspiration with four consecutive aliquots on the number of nucleated cells (NCs) and colony-forming units (CFUs) in concentrated bone marrow aspirate (cBMA) taken from the proximal humerus.MethodscBMA was taken from the proximal humerus of patients undergoing arthroscopic rotator cuff surgery. Four 12-mL double syringes were used consecutively from a single trocar to obtain four 10 cc aliquots. Each then underwent centrifugation to create a fractionated layer rich in nucleated cells. Following cellular separation, NCs were counted and CFUs were evaluated after incubation of 7–10 days. Cellular comparisons between each aliquot were performed along with their interaction with patient age and sex.ResultsTwenty-nine patients (55.9 ± 4.6 years) were included in this study. The number of NCs and CFUs showed significant differences between the four aliquots of aspirate, with the first 10 cc aliquot providing the highest amount (p < 0.001, respectively). No significant differences were found between the sum of the three sequential aliquots compared to the initial 10 cc sample. There were no significant differences between male and female patients (p > 0.05). Increasing age resulted in no significant decrease in the number of NCs and CFUs across the four consecutive aliquots (p > 0.05).ConclusionIn conclusion, while the initial aliquot provided the greatest number of nucleated cells and cultured CFUs, the addition of each sequential volume aspirate yielded similar amounts in total. This demonstrates the potential effectiveness of obtaining of higher volume aspirates from the proximal humerus during rotator cuff repair.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The effect of a single consecutive volume aspiration on concentrated bone marrow from the proximal humerus for clinical application

Muench¹,

Kia

Otto

et al. 2019

BMC Musculoskelet Disord

Self Cite

View full text Add to dashboard Cite

show abstract

“…This method of using multiple syringes was performed in order to prevent an excessive ratio of anticoagulant, in case 60 ml of BMA was unable to be obtained in each syringe. The BMA was transferred to a light absorption sensor technology system (Angel System, Arthrex, Naples, FL, USA) and concentrated using a 15% hematocrit setting (cBMA) (17). This setting was chosen based on preliminary data showing no significant changes in cellular yield, when using a higher concentration setting.…”

Section: Concentrated Bone Marrow Aspirate (Cbma)mentioning

confidence: 99%

Concentrated Bone Marrow Aspirate and Subacromial Bursa-Derived Cells Demonstrate Similar Cellular Adhesion and Proliferation Potential on Demineralized Bone Matrix Scaffolds for Biologic Augmentation of Rotator Cuff Repair

Muench

Berthold

Kia

et al. 2020

Muscle Ligaments and Tendons J

View full text Add to dashboard Cite

Background. Specific scaffolds are still required to sufficiently deliver and retain applied mesenchymal stem cells (MSCs) of various origins to the targeted zone of repaired tissue. The purpose of the study was to evaluate the demineralized bone matrix (DBM) as a scaffold for concentrated bone marrow aspirate (cBMA), subacromial bursa-derived cells (SBDCs), tenocytes, and osteoblasts. Methods. cBMA was harvested from the proximal humerus along with tenocytes and subacromial bursal tissue during arthroscopic shoulder surgery. Human osteoblasts were obtained from femoral condyles of patients undergoing total knee arthroplasty. Cells were seeded on a DBM scaffold. Cellular adhesion and proliferation assays were performed for each scaffold sample. Half of cBMA underwent arthroscopic simulation of being washed to mimic the intraoperative environment. Results. There was no significant difference in cellular adhesion potential on DBM scaffolds (p=0.168) when comparing SBDCs (mean±SD: 25,775±11,351), osteoblasts (mean±SD: 33,113±2,709), tenocytes (mean±SD: 25,000±3,864) and cBMA (mean±SD: 25,025±6,206). Osteoblasts (mean±SD: 0.279±0.009) showed a significantly higher proliferation potential (p=0.021, respectively) compared to SBDCs (mean±SD: 0.248±0.015), tenocytes (mean±SD: 0.239±0.011), and cBMA (mean±SD: 0.247±0.007). Histology sections and electron microscopy confirmed the presence of cells within the matrix of scaffolds. Conclusions. SBDCs and cBMA demonstrated high cellular adhesion and proliferation potential on DBM scaffolds.

show abstract

“… 1 , 2 , 7 , 8 , 9 Donor sites include the anterior and posterior iliac crest, proximal humerus, and distal femur. 2 , 7 , 10 , 11 , 12 Additional work has discussed the presence of these cells in subacromial bursa tissue as well. 13 , 14 , 15 , 16 , 17 These studies call into question the routine debridement and disposal of this tissue.…”

mentioning

confidence: 99%

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

Landry

Levy

McCarthy

et al. 2020

Arthroscopy, Sports Medicine, and Rehabilitation

Self Cite

View full text Add to dashboard Cite

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.

show abstract

The Influence of Trocar Fenestration and Volume on Connective Tissue Progenitor Cells (Stem Cells) in Arthroscopic Bone Marrow Aspiration From the Proximal Humerus

Cited by 12 publications

References 27 publications

The effect of a single consecutive volume aspiration on concentrated bone marrow from the proximal humerus for clinical application

The effect of a single consecutive volume aspiration on concentrated bone marrow from the proximal humerus for clinical application

Concentrated Bone Marrow Aspirate and Subacromial Bursa-Derived Cells Demonstrate Similar Cellular Adhesion and Proliferation Potential on Demineralized Bone Matrix Scaffolds for Biologic Augmentation of Rotator Cuff Repair

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

Contact Info

Product

Resources

About