Purpose
The purpose of this study was to evaluate the number of colony-forming units (CFUs)
derived from concentrated bone marrow aspirates (BMAs) that were processed following
arthroscopic harvest from either the proximal humerus or the body of the ilium during
biologic augmentation of the rotator cuff and acetabular labral repairs.
Methods
Between November 2014 and January 2019, BMA was harvested from the proximal humerus
(n = 89) and the body of the ilium (n = 30) during arthroscopic surgery. Following
concentration of the aspirate, a 0.5-mL aliquot was further processed and the number
of nucleated cells (NC) was counted. Each aliquot was cultured until CFUs were quantifiable.
Fluorescence-activated cell sorting analysis and quantitative polymerase chain reaction
was performed to confirm presence of mesenchymal stem cells. BMA harvest sites were
prospectively assessed and evaluated for differences in age, sex, volume of aspirated
BM, and CFUs per milliliter of BMA.
Results
The prevalence (38.57 ± 27.92ilium vs. 56.00 ± 25.60humerus CFUs per 106 nucleated cells) and concentration (979.17 ± 740.31ilium vs. 1,516.62 ± 763.63humerus CFUs per 1.0 mL BMA) of CFUs was significantly higher (P < .001, respectively) for BMA harvested from the proximal humerus. Additionally,
the estimated total number of cells was significantly higher (P = .013) in BMA from the proximal humerus (97,529.00 ± 91,064.01ilium vs. 130,552.4 ± 85,294.2humerus). There was no significant difference between groups regarding BMA volume (91.67
± 18.77ilium vs. 85.63 ± 35.61humerus mL; P = .286) and NC count (24.01 ± 5.13ilium vs. 27.07 ± 6.28humerus × 106 per mL BMA; P = .061). The mean age was significantly lower (P < .001) in patients with BMA being harvested from the ilium (30.18 ± 7.63ilium vs. 56.82 ± 7.08humerus years). Patient sex and age had no significant influence on cellular measures within
groups (P > .05, respectively).
Conclusion
Both proximal humerus and the body of the ilium can be considered reliable sources
of bone marrow aspirate for the use in biologic augmentation during their respective
arthroscopic surgery. Samples of bone marrow aspirate from the proximal humerus yielded
a significantly higher amount of CFUs when compared with samples of BMA obtained from
the ilium.
Level of Evidence: Level II- prospective laboratorial study.
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Article Info
Publication History
Published online: June 15, 2020
Accepted:
June 4,
2020
Received:
November 11,
2019
See commentary on page 2412Footnotes
The authors report the following potential conflicts of interest or sources of funding: A.D.M. has received research support and consulting fees from Arthrex , outside the submitted work. The University of Connecticut Health Center/UConn Musculoskeletal Institute receives funding from Arthrex (Naples, Fl, USA). The company had no influence on study design, data collection or interpretation of the results or the final manuscript. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
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