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


Journal

BMC musculoskeletal disorders
ISSN: 1471-2474
Titre abrégé: BMC Musculoskelet Disord
Pays: England
ID NLM: 100968565

Informations de publication

Date de publication:
14 Nov 2019
Historique:
received: 08 04 2019
accepted: 31 10 2019
entrez: 16 11 2019
pubmed: 16 11 2019
medline: 9 4 2020
Statut: epublish

Résumé

Low 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. cBMA 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. Twenty-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). In 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.

Sections du résumé

BACKGROUND BACKGROUND
Low 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.
METHODS METHODS
cBMA 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.
RESULTS RESULTS
Twenty-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).
CONCLUSION CONCLUSIONS
In 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.

Identifiants

pubmed: 31727036
doi: 10.1186/s12891-019-2924-2
pii: 10.1186/s12891-019-2924-2
pmc: PMC6857344
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

543

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Auteurs

Lukas N Muench (LN)

Department of Orthopaedic Sports Medicine, Technical University, Munich, Germany. lukas.muench@tum.de.

Cameron Kia (C)

Department of Orthopaedic Surgery, University of Connecticut, Farmington, CT, USA.

Alexander Otto (A)

Department of Orthopaedic Surgery, University of Connecticut, Farmington, CT, USA.

Julian Mehl (J)

Department of Orthopaedic Sports Medicine, Technical University, Munich, Germany.
Department of Orthopaedic Surgery, University of Connecticut, Farmington, CT, USA.

Joshua B Baldino (JB)

Department of Orthopaedic Surgery, University of Connecticut, Farmington, CT, USA.

Mark P Cote (MP)

Department of Orthopaedic Surgery, University of Connecticut, Farmington, CT, USA.

Mary Beth McCarthy (MB)

Department of Orthopaedic Surgery, University of Connecticut, Farmington, CT, USA.

Knut Beitzel (K)

Department of Orthopaedic Sports Medicine, Technical University, Munich, Germany.
Department of Shoulder Surgery, ATOS Clinic, Cologne, Germany.

Augustus D Mazzocca (AD)

Department of Orthopaedic Surgery, University of Connecticut, Farmington, CT, USA.

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