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关节镜手术中取自肱骨头近端和股骨远端的间充质干细胞(成骨前体细胞)的比较。

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

机构信息

Department of Orthopaedic Surgery, University of Connecticut Health Center, Farmington, Connecticut, USA.

出版信息

Arthroscopy. 2013 Feb;29(2):301-8. doi: 10.1016/j.arthro.2012.08.021. Epub 2013 Jan 3.

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.

摘要

目的

本研究旨在探讨关节镜手术中从肱骨头近端和股骨远端抽吸的浓缩骨髓(BM)中年龄、性别与活间充质干细胞(MSCs)数量之间的关系。

方法

84 例患者(51.3±11.6 岁)在关节镜手术中分别从肱骨头(n=55)或股骨远端(n=29)抽吸 BM。将骨髓经 5 分钟 1500rpm 离心后获得 MSCs。计算 BM 体积和有核细胞(NC)数量,并将样本培养 6 天,之后定量集落形成单位(CFUs)并进行荧光激活细胞分选(FACS)分析。采用简单线性回归探讨年龄、性别、抽吸 BM 体积和每毫升 MSC 数量之间的关系。

结果

BM 抽吸平均获得 22.6±12.3ml。离心后,浓缩 BM 中收获 30.0±16.7×10(6)个有核细胞/ml。肱骨头提供 38.7±52.6×10(6)个,股骨远端提供 25.9±14.3×10(6)个,浓缩 BM 中总体 MSC 为 766.3±545.3 个/ml(肱骨头:883.9±577.6 个,股骨远端:551.3±408.1 个)。年龄、性别或供体部位对值无显著影响。

结论

关节镜从肱骨头和股骨远端抽吸骨髓是一种可重复的技术,可获得可靠浓度的 MSC。使用术中浓缩方法,在所有临床相关年龄段均获得一致数量的 MSC,而分离的 MSC 数量没有明显下降。

临床意义

浓缩骨髓抽吸物来源的人 MSC 是一种很有前途的生物添加物,在未来软组织增强中可能具有实际用途。不需要额外的抽吸部位(如髂嵴)或第二个手术程序的关节镜骨髓抽吸技术可能会促进 MSC 在关节镜手术中的未来应用。

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