Department of Orthopaedic Surgery, University of Connecticut Health Center, Farmington, Connecticut 06031, USA.
Arthroscopy. 2012 Jan;28(1):74-84. doi: 10.1016/j.arthro.2011.06.035. Epub 2011 Oct 11.
(1) To safely obtain bone marrow aspirates from the distal femur during arthroscopic knee surgery, (2) to purify and efficiently concentrate connective tissue progenitor cells (CTPs) in the operating room (OR), and (3) to confirm that these are CTPs through their ability to differentiate into bone cells.
Bone marrow aspirates were harvested from the distal femur during arthroscopic knee surgery in 26 patients. Twenty-five matched control subjects were selected to evaluate for increased incidence of complications. CTPs were isolated using a rapid method designed for use in the OR compared with 2 accepted methods. Cytochemical and molecular analysis was used to assess osteogenic potential.
Osteogenic potential of the CTPs was confirmed by reverse transcription polymerase chain reaction analysis and cellular staining. Bone marrow was successfully aspirated in 25 cases, with 3 incidences of stiffness in the aspirate group compared with 2 in the control group, 1 incidence of a wound irregularity in the aspirate group compared with 1 in the control group, and 3 incidences of hemarthrosis/persistent effusion in the aspirate group compared with 1 in the control group. The rate of complications for the aspirate group was 36% compared with 25% in the control group.
Our intention was to develop a technique for extracting and purifying bone marrow so that the orthopaedic surgeon would have a simple, safe, and efficient process by which to isolate CTPs during arthroscopic knee surgery. This method of aspiration did not lead to a significant increase in complications. Further bone marrow aspirate was successfully purified in the OR, with only a slight increase in surgery time, and resulted in a fractionated layer rich with CTPs. These cells showed osteogenic potential, as evidenced by their osteoblastic differentiation. These CTPs may have future use in enhancing the incorporation of the graft into the bone.
Level III, matched case-control study.
（1）在关节镜膝关节手术中安全地从股骨远端获取骨髓抽吸物，（2）在手术室（OR）中纯化和有效地浓缩结缔组织祖细胞（CTP），（3）通过其分化为成骨细胞的能力确认这些是 CTP。
在 26 例关节镜膝关节手术中从股骨远端采集骨髓抽吸物。选择 25 名匹配的对照者以评估并发症发生率增加的情况。与 2 种公认的方法相比，使用专为 OR 设计的快速方法分离 CTP。使用细胞化学和分子分析评估成骨潜能。
通过逆转录聚合酶链反应分析和细胞染色证实了 CTP 的成骨潜能。25 例成功进行了骨髓抽吸，抽吸组有 3 例出现抽吸物僵硬，对照组有 2 例；抽吸组有 1 例伤口不规则，对照组有 1 例；抽吸组有 3 例关节积血/持续渗液，对照组有 1 例。抽吸组的并发症发生率为 36%，对照组为 25%。
我们的目的是开发一种提取和纯化骨髓的技术，以便矫形外科医生在关节镜膝关节手术中有一个简单、安全、高效的过程来分离 CTP。这种抽吸方法并没有导致并发症发生率显著增加。进一步的骨髓抽吸在 OR 中成功纯化，仅略微增加手术时间，并产生富含 CTP 的分层。这些细胞表现出成骨潜能，这表现为它们的成骨细胞分化。这些 CTP 可能在增强移植物与骨骼的结合方面有未来的用途。
III 级，匹配病例对照研究。
