Anz Adam W, Branch Eric A, Rodriguez John, Chillemi Fellipo, Bruce Jeremy R, Murphy Matthew B, Suzuki Richard K, Andrews James R
Andrews Institute for Orthopaedics & Sports Medicine, Gulf Breeze, Florida, U.S.A..
Andrews Institute for Orthopaedics & Sports Medicine, Gulf Breeze, Florida, U.S.A.
Arthroscopy. 2017 Apr;33(4):790-797. doi: 10.1016/j.arthro.2016.09.036. Epub 2016 Dec 30.
To examine the number of viable stem cells contained in the postinjury effusion fluid and the waste byproducts of arthroscopic cruciate ligament surgery.
This study included patients older than 18 years of age with acute (<5 weeks old) cruciate ligament injuries requiring arthroscopic surgery. The postinjury effusion fluid (effusion fluid), fat pad and cruciate ligament stump debridement tissue (byproduct tissue), and arthroscopic fluid collected during fat pad and/or stump debridement (byproduct fluid) were collected at the time of surgery from 30 individuals. Specimens were analyzed, investigating cell viability, nucleated cell counts, cell concentrations, colony-forming unit assays, and flow cytometry. Samples from the first 20 individuals were collected in small specimen containers, and samples from the last 10 individuals were collected in larger specimen containers.
Cells of the injury effusion exhibited the greatest viability (86.4 ± 1.31%) when compared with the small volume harvest byproduct tissue (50.2 ± 2.5%, P = .0001), small volume harvest byproduct fluid (48.8 ± 1.88%, P = .0001), large volume harvest byproduct tissue (70.1 ± 5.6%, P = .0001), and large volume harvest byproduct fluid (60.3 ± 3.41%, P = .0001). The culture analysis of fibroblast colony-forming units found on average 1916 ± 281 progenitor cells in the effusion fluid, 2488 ± 778 progenitor cells in the byproduct tissue, and 2357 ± 339 progenitor cells in the byproduct fluid. Flow cytometry confirmed the presence of immature cells and the presence of cells with markers typically expressed by known stem cell populations.
Viable stem cells are mobilized to the postinjury effusion at the time of cruciate ligament injury and can be found in the byproduct waste of cruciate ligament surgery.
The methodology around effusion fluid and byproduct tissue capture during cruciate ligament surgery should be investigated further. Cell amounts available from these tissues with current technologies are not sufficient for immediate evidence-based clinical application.
研究关节镜下十字韧带手术后损伤后积液及废弃物中所含存活干细胞的数量。
本研究纳入年龄大于18岁、急性（<5周龄）十字韧带损伤且需进行关节镜手术的患者。在手术时从30例患者中收集损伤后积液（积液）、脂肪垫及十字韧带残端清创组织（副产物组织），以及在脂肪垫和/或残端清创过程中收集的关节镜冲洗液（副产物液）。对标本进行分析，研究细胞活力、有核细胞计数、细胞浓度、集落形成单位测定及流式细胞术。前20例患者的样本收集于小标本容器中，后10例患者的样本收集于大标本容器中。
与小容量采集的副产物组织（50.2±2.5%，P = .0001）、小容量采集的副产物液（48.8±1.88%，P = .0001）、大容量采集的副产物组织（70.1±5.6%，P = .0001）及大容量采集的副产物液（60.3±3.41%，P = .0001）相比，损伤积液中的细胞活力最高（86.4±1.31%）。对成纤维细胞集落形成单位的培养分析发现，积液中平均有1916±281个祖细胞，副产物组织中有2488±778个祖细胞，副产物液中有2357±339个祖细胞。流式细胞术证实存在未成熟细胞以及具有已知干细胞群体典型表达标志物的细胞。
十字韧带损伤时，存活干细胞被动员至损伤后积液中，且可在十字韧带手术的副产物废弃物中发现。
十字韧带手术期间积液及副产物组织采集的方法应进一步研究。利用现有技术从这些组织中获取的细胞数量不足以立即用于循证临床应用。
