肱骨近端和髂骨是关节镜手术中生物增强时骨髓抽吸的可靠来源。
Proximal Humerus and Ilium Are Reliable Sources of Bone Marrow Aspirates for Biologic Augmentation During Arthroscopic Surgery.
机构信息
Department of Orthopaedic Surgery, UConn Musculoskeletal Institute, University of Connecticut, Farmington, Connecticut, U.S.A.; Department of Orthopaedic Sports Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany; Department of Trauma, Orthopaedic, Plastic and Hand Surgery, University Hospital of Augsburg, Augsburg, Germany.
Department of Orthopaedic Surgery, UConn Musculoskeletal Institute, University of Connecticut, Farmington, Connecticut, U.S.A.; Department of Orthopaedic Sports Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.
出版信息
Arthroscopy. 2020 Sep;36(9):2403-2411. doi: 10.1016/j.arthro.2020.06.009. Epub 2020 Jun 15.
PURPOSE
The purpose of this study was to evaluate the number of colony-forming units (CFUs) derived from concentrated bone marrow aspirates (BMAs) that were processed following arthroscopic harvest from either the proximal humerus or the body of the ilium during biologic augmentation of the rotator cuff and acetabular labral repairs.
METHODS
Between November 2014 and January 2019, BMA was harvested from the proximal humerus (n = 89) and the body of the ilium (n = 30) during arthroscopic surgery. Following concentration of the aspirate, a 0.5-mL aliquot was further processed and the number of nucleated cells (NC) was counted. Each aliquot was cultured until CFUs were quantifiable. Fluorescence-activated cell sorting analysis and quantitative polymerase chain reaction was performed to confirm presence of mesenchymal stem cells. BMA harvest sites were prospectively assessed and evaluated for differences in age, sex, volume of aspirated BM, and CFUs per milliliter of BMA.
RESULTS
The prevalence (38.57 ± 27.92 vs. 56.00 ± 25.60 CFUs per 10 nucleated cells) and concentration (979.17 ± 740.31 vs. 1,516.62 ± 763.63 CFUs per 1.0 mL BMA) of CFUs was significantly higher (P < .001, respectively) for BMA harvested from the proximal humerus. Additionally, the estimated total number of cells was significantly higher (P = .013) in BMA from the proximal humerus (97,529.00 ± 91,064.01 vs. 130,552.4 ± 85,294.2). There was no significant difference between groups regarding BMA volume (91.67 ± 18.77 vs. 85.63 ± 35.61 mL; P = .286) and NC count (24.01 ± 5.13 vs. 27.07 ± 6.28 × 10 per mL BMA; P = .061). The mean age was significantly lower (P < .001) in patients with BMA being harvested from the ilium (30.18 ± 7.63 vs. 56.82 ± 7.08 years). Patient sex and age had no significant influence on cellular measures within groups (P > .05, respectively).
CONCLUSION
Both proximal humerus and the body of the ilium can be considered reliable sources of bone marrow aspirate for the use in biologic augmentation during their respective arthroscopic surgery. Samples of bone marrow aspirate from the proximal humerus yielded a significantly higher amount of CFUs when compared with samples of BMA obtained from the ilium.
LEVEL OF EVIDENCE
Level II- prospective laboratorial study.
目的
本研究旨在评估在关节镜下取自肱骨头近端（n=89）或髂骨体（n=30）的浓缩骨髓抽吸物（BMA）在进行生物增强的情况下，经过关节镜收获后，产生的集落形成单位（CFU）的数量。用于修复肩袖和髋臼唇。
方法
2014 年 11 月至 2019 年 1 月期间，在关节镜手术中从肱骨头近端（n=89）和髂骨体（n=30）采集 BMA。在浓缩抽吸物后，进一步处理 0.5 毫升等分试样，并计算有核细胞（NC）的数量。每个等分试样都被培养，直到可以定量 CFU。荧光激活细胞分选分析和定量聚合酶链反应用于确认间充质干细胞的存在。前瞻性评估 BMA 采集部位，并评估年龄、性别、抽吸的 BM 体积和每毫升 BMA 的 CFU 数量的差异。
结果
CFU 的流行率（38.57±27.92 与 56.00±25.60 CFU/10 个有核细胞）和浓度（979.17±740.31 与 1,516.62±763.63 CFU/1.0 mL BMA）在肱骨头近端采集的 BMA 中明显更高（P<0.001，分别）。此外，肱骨头近端 BMA 的总细胞数量估计值明显更高（P=0.013）（97,529.00±91,064.01 与 130,552.4±85,294.2）。两组间 BMA 体积（91.67±18.77 与 85.63±35.61 mL；P=0.286）和 NC 计数（24.01±5.13 与 27.07±6.28×10 个有核细胞/mL BMA；P=0.061）无显著差异。髂骨采集的 BMA 患者的平均年龄明显较低（P<0.001）（30.18±7.63 与 56.82±7.08 岁）。患者性别和年龄对组内细胞测量没有显著影响（分别为 P>0.05）。
结论
肱骨头近端和髂骨体均可作为关节镜下各自手术中生物增强时使用的可靠骨髓抽吸物来源。与从髂骨获得的 BMA 相比，肱骨头近端采集的骨髓抽吸物产生的 CFU 数量明显更多。
证据水平
二级-前瞻性实验室研究。
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