Dragoo Jason L, Guzman Roberto A
Department of Orthopaedic Surgery, Stanford University Medical Center, Stanford, California, USA.
Orthop J Sports Med. 2020 Jan 17;8(1):2325967119893634. doi: 10.1177/2325967119893634. eCollection 2020 Jan.
Bone marrow aspirate (BMA) concentrate (BMAC) has gained popularity as a treatment modality for various orthopaedic conditions; however, there are still inconsistencies in its reported therapeutic efficacy. This may be because of the many different commercial BMAC preparation systems used clinically, which generate dissimilar concentrate products.
To compare 3 commercially available BMAC preparation systems: Harvest SmartPrep 3, Biomet BioCUE, and Arthrex Angel. We evaluated the consistency of each of these systems and compared the composition of their concentrate products.
Controlled laboratory study.
A total of 10 patients donated whole blood and BMA, which were combined and processed with the 3 different BMAC preparation systems. Samples were taken before and after processing for the measurement of white blood cells (WBC), platelets (PLT), CD34+ cells, and colony-forming unit-fibroblast (CFU-F). To evaluate consistency, the variances of cell yield and concentration increase from baseline for each cell type were compared between systems. To compare concentrate product composition, differences between the systems' mean cell yield and concentration increase from baseline for each cell type were evaluated.
The Harvest system (variance, 0.25) concentrated WBC more consistently than the Arthrex system (variance, 3.25) ( = .024), but no other differences in consistency were noted between the 3 systems. The Harvest system recovered the greatest percentage of CFU-F (82.4% ± 18.2%), CD34+ cells (81.1% ± 28.5%), and WBC (77.3% ± 8.6%), whereas the Biomet system recovered the greatest percentage of PLTs (92.9% ± 27.3%). The Arthrex system concentrated PLT to the greatest degree (11.10 ± 2.05 times baseline), while the Biomet system concentrated WBC to the greatest degree (5.99 ± 1.04 times baseline).
The consistency of the 3 systems was similar for all but 1 of the evaluated cell types. However, the composition of the concentrate products differed across systems. This may grant each system unique advantages without having to sacrifice reproducibility.
Understanding the consistency of different BMAC preparation systems and their product makeup may aid in determining optimal therapeutic doses of different cell types.
骨髓抽吸物（BMA）浓缩物（BMAC）作为一种治疗多种骨科疾病的方法已受到广泛关注；然而，其报道的治疗效果仍存在不一致性。这可能是由于临床使用的多种不同商业BMAC制备系统会产生不同的浓缩产品。
比较3种市售BMAC制备系统：Harvest SmartPrep 3、Biomet BioCUE和Arthrex Angel。我们评估了每种系统的一致性，并比较了它们浓缩产品的成分。
对照实验室研究。
共有10名患者捐献了全血和BMA，将其混合并用3种不同的BMAC制备系统进行处理。在处理前后采集样本，用于测量白细胞（WBC）、血小板（PLT）、CD34 +细胞和成纤维细胞集落形成单位（CFU-F）。为评估一致性，比较了各系统之间每种细胞类型的细胞产量方差和相对于基线的浓度增加情况。为比较浓缩产品成分，评估了各系统之间每种细胞类型的平均细胞产量和相对于基线的浓度增加差异。
Harvest系统（方差为0.25）浓缩白细胞的一致性高于Arthrex系统（方差为3.25）（P = 0.024），但在其他细胞类型的一致性方面，3种系统之间未发现差异。Harvest系统回收的CFU-F（82.4%±18.2%）、CD34 +细胞（81.1%±28.5%）和白细胞（77.3%±8.6%）百分比最高，而Biomet系统回收的血小板（PLT）百分比最高（92.9%±27.3%）。Arthrex系统浓缩血小板的程度最高（11.10±2.05倍基线），而Biomet系统浓缩白细胞的程度最高（5.99±1.04倍基线）。
除一种评估的细胞类型外，3种系统在其他所有细胞类型上的一致性相似。然而，不同系统的浓缩产品成分存在差异。这可能使每个系统都具有独特优势，而无需牺牲可重复性。
了解不同BMAC制备系统的一致性及其产品构成可能有助于确定不同细胞类型的最佳治疗剂量。
