Comparison of mesenchymal stem cells (osteoprogenitors) harvested from proximal humerus and distal femur during arthroscopic surgery.

ABSTRACT

PURPOSE: The aim of this study was to examine the relations between age, gender, and number of viable mesenchymal stem cells (MSCs) in concentrated bone marrow (BM) obtained from the proximal humerus and distal femur during arthroscopic surgery. METHODS: BM was aspirated from either the proximal humerus (n = 55) or distal femur (n = 29) during arthroscopic surgery in 84 patients (51.3 ± 11.6 years). MSCs were obtained from fractionated bone marrow after a 5-minute spin at 1,500 rpm. Volume of BM and number of nucleated cells (NCs) were calculated, and samples were cultured for 6 days, after which point colony-forming units (CFUs) were quantified and fluorescence-activated cell sorting (FACS) analysis was performed. Simple linear regression was used to explore relations between age, gender, volume of aspirated BM, and MSCs per milliliter. RESULTS: BM aspirations yielded a mean quantity of 22.6 ± 12.3 mL. After centrifugation, 30.0 ± 16.7 × 10(6) nucleated cells/mL of concentrated BM were harvested. The proximal humerus provided 38.7 ± 52.6 × 10(6), and the distal femur, 25.9 ± 14.3 × 10(6), for an overall 766.3 ± 545.3 MSCs/mL of concentrated BM (proximal humerus 883.9 ± 577.6, distal femur 551.3 ± 408.1). Values did not significantly differ by age, gender, or donor site. CONCLUSIONS: Arthroscopic aspiration of bone marrow from the proximal humerus and distal femur is a reproducible technique and yields reliable concentrations of MSCs. The use of an intraoperative concentration method resulted in consistent amounts of MSCs in all clinically relevant age groups without a significant drop of the number of isolated MSCs. CLINICAL RELEVANCE Human MSCs derived from concentrated bone marrow aspirate are a promising biological addition that may have practical use in the future of soft tissue augmentation. Arthroscopic techniques for bone marrow aspiration that do not require an additional surgical site for aspiration (e.g., iliac crest) or a second operative procedure may facilitate future use of MSCs in arthroscopic surgery.