Stoker Aaron M, Baumann Charles A, Stannard James P, Cook James L
Department of Orthopaedic Surgery/Thompson Laboratory for Regenerative Orthopaedics, Missouri Orthopaedic Institute, University of Missouri, Columbia, Missouri.
J Knee Surg. 2018 Apr;31(4):314-320. doi: 10.1055/s-0037-1603800. Epub 2017 Jun 24.
Fresh osteochondral allograft (OCA) transplantation is an attractive treatment option for symptomatic articular cartilage lesions in young, healthy patients. Since a lack of OCA bone integration can be a cause of treatment failure, methods for speeding and enhancing OCA bone integration to mitigate this potential complication are highly desirable. This study sought to determine and compare the potential of bone marrow aspirate concentrate (BMC) and leukoreduced platelet rich plasma (PRP) to repopulate the osseous portion of an OCA with cells and deliver osteogenic proteins. It was hypothesized that BMC would have significantly higher colony forming units (CFUs)/mL and seed the osseous portion of OCA with more cells than PRP. Finally, we hypothesized that the media of BMC and PRP treated OCAs would have significantly higher concentrations of osteogenic proteins compared with negative control OCAs. Cylindrical OCAs ( = 36) created from tissue stored for 21 days were treated with BMC ( = 12) or PRP ( = 12) obtained for 6 dogs, or left untreated as a negative control ( = 12). After treatment, OCAs were cultured for 7 or 14 days. Media were collected for analysis of osteogenic biomarker concentration. Samples of each BMC and PRP were tested for CFU concentration. On day 7 or 14, the grafts were assessed for cell surface adhesion and penetration using fluorescent microscopy. Significant differences in CFU and media biomarker concentration between the groups were determined using one-way analysis of variance (ANOVA) and Tukey's post-hoc test with the significance set at < 0.05. Only OCAs saturated with BMC had viable cells detectable on the osseous portion of the allografts at day 7 and 14 of culture. BMC samples had a significantly higher ( = 0.029) CFU/mL compared with PRP samples. At day 3 and/or 7 of culture, the concentration of several osteogenic proteins was significantly higher in both BMC and PRP samples. Autogenous BMC can be used to deliver both a cell population and osteogenic proteins that may improve healing of the osseous portion of the OCA clinically.
新鲜骨软骨异体移植（OCA）对于年轻健康患者的症状性关节软骨损伤而言是一种有吸引力的治疗选择。由于缺乏OCA骨整合可能是治疗失败的一个原因，因此非常需要加快和增强OCA骨整合以减轻这种潜在并发症的方法。本研究旨在确定并比较骨髓抽吸浓缩物（BMC）和白细胞滤除富血小板血浆（PRP）用细胞重新填充OCA骨部分并递送成骨蛋白的潜力。研究假设BMC将具有显著更高的集落形成单位（CFU）/mL，并且与PRP相比能为OCA骨部分植入更多细胞。最后，我们假设与阴性对照OCA相比，经BMC和PRP处理的OCA的培养基将具有显著更高浓度的成骨蛋白。从储存21天的组织制备的圆柱形OCA（n = 36）用从6只狗获得的BMC（n = 12）或PRP（n = 12）处理，或作为阴性对照不进行处理（n = 12）。处理后，OCA培养7天或14天。收集培养基用于分析成骨生物标志物浓度。对每个BMC和PRP样本检测CFU浓度。在第7天或第14天，使用荧光显微镜评估移植物的细胞表面粘附和穿透情况。使用单因素方差分析（ANOVA）和Tukey事后检验确定组间CFU和培养基生物标志物浓度的显著差异，显著性设定为P < 0.05。在培养第7天和第14天，仅用BMC饱和的OCA在同种异体移植物的骨部分可检测到活细胞。与PRP样本相比，BMC样本的CFU/mL显著更高（P = 0.029）。在培养第3天和/或第7天，BMC和PRP样本中几种成骨蛋白的浓度均显著更高。自体BMC可用于递送细胞群和成骨蛋白，这在临床上可能改善OCA骨部分的愈合。
