Purpose
The purpose of this study is to determine whether concentrated bone marrow aspirate
(cBMA) from the posterior superior iliac spine (PSIS) or proximal humerus (PH) produces
a more productive cellular harvest in patients undergoing arthroscopic rotator cuff
repair.
Methods
Patients under 80 years old undergoing surgery for arthroscopic rotator cuff repair
were enrolled. Two 60 mL aliquots of BMA were harvested from each subject, one from
the PSIS and one from the PH. Each aliquot was processed independently to create cBMA.
Cellular composition was determined using an automated hemocytometer and proliferative
potential was studied with colony forming unit (CFU) assays.
Results
Twelve patients were recruited (7 male, 5 female). The average age was 64.3 years
(range 46.1-77.25 years) with body mass index of 26.8 (range 20.0-34.3). The average
total nucleated cells (TNC) from PH was 18.7 × 106 cells/mL (95% confidence interval [CI], 4.4-33.0; standard deviation [SD], 24.8)
with 3.9 CFU/mL (95% CI, 0.3-7.5, SD, 5.7). The average TNC count from the PSIS was
55.9 × 106 cells/mL (95% CI, 25.3-86.4; SD, 52.9) with 32.5 CFU/mL (95% CI, 11.5-53.5; SD, 33.1).
The PSIS had a 3.0 times greater total nucleated cell yield (P = .014) and 8.3 times greater number of CFU/mL (P = .024) when compared to the PH. The average harvest time from the PSIS was 5.6 minutes
and from the PH was 11.0 minutes (P = .043); harvest time did not account for additional time to prep and drape the PSIS.
Conclusions
The cBMA harvested from the PSIS resulted in a 3.0 times greater cellular yield and
an 8.3 times greater proliferative product than cBMA from the PH. Clinical Relevance: When a more cellular cBMA product is sought to augment rotator cuff tear repair
surgery, the PSIS is the preferred site for harvest.
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Article info
Publication history
Published online: October 25, 2021
Accepted:
October 16,
2021
Received:
June 2,
2021
Footnotes
The authors report the following potential conflict of interest or source of funding: The Andrews Research and Education Foundation receives research support from Arthrex and KLSMC Stem Cell. A.A. reports research support, speaking reimbursement and royalties from Arthrex. Arthrex sponsored the execution of this study with grant number US19012. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Identification
Copyright
© 2022 Published by Elsevier on behalf of the Arthroscopy Association of North America
