Nallakumarasamy Arulkumar, Shrivastava Sandeep, Rangarajan Ravi Velamoor, Jeyaraman Naveen, Devadas Avinash Gandi, Ramasubramanian Swaminathan, Jeyaraman Madhan
Department of Orthopaedics, Datta Meghe Institute of Higher Education and Research, Wardha 442004, Maharashtra, India.
Department of Regenerative Medicine, Mother Cell Regenerative Centre, Tiruchirappalli 620017, Tamil Nadu, India.
World J Methodol. 2025 Jun 20;15(2):101458. doi: 10.5662/wjm.v15.i2.101458.
Knee osteoarthritis (OA) is a debilitating condition with limited long-term treatment options. The therapeutic potential of mesenchymal stem cells (MSCs), particularly those derived from bone marrow aspirate concentrate, has garnered attention for cartilage repair in OA. While the iliac crest is the traditional site for bone marrow harvesting (BMH), associated morbidity has prompted the exploration of alternative sites such as the proximal tibia, distal femur, and proximal humerus. This paper reviews the impact of different harvesting sites on mesenchymal stem cell (MSC) yield, viability, and regenerative potential, emphasizing their relevance in knee OA treatment. The iliac crest consistently offers the highest MSC yield, but alternative sites within the surgical field of knee procedures offer comparable MSC characteristics with reduced morbidity. The integration of harvesting techniques into existing knee surgeries, such as total knee arthroplasty, provides a less invasive approach while maintaining therapeutic efficacy. However, variability in MSC yield from these alternative sites underscores the need for further research to standardize techniques and optimize clinical outcomes. Future directions include large-scale comparative studies, advanced characterization of MSCs, and the development of personalized harvesting strategies. Ultimately, the findings suggest that optimizing the site of BMH can significantly influence the quality of MSC-based therapies for knee OA, enhancing their clinical utility and patient outcomes.
膝关节骨关节炎（OA）是一种使人衰弱的疾病，长期治疗选择有限。间充质干细胞（MSCs），尤其是源自骨髓抽吸浓缩物的间充质干细胞，在OA软骨修复方面的治疗潜力已受到关注。虽然髂嵴是传统的骨髓采集（BMH）部位，但相关的发病率促使人们探索替代部位，如胫骨近端、股骨远端和肱骨近端。本文综述了不同采集部位对间充质干细胞（MSC）产量、活力和再生潜力的影响，强调了它们在膝关节OA治疗中的相关性。髂嵴始终能提供最高的MSC产量，但膝关节手术视野内的替代部位能提供具有可比MSC特性且发病率较低的结果。将采集技术整合到现有的膝关节手术中，如全膝关节置换术，在保持治疗效果的同时提供了一种侵入性较小的方法。然而，这些替代部位MSC产量的可变性突出了进一步研究以规范技术和优化临床结果的必要性。未来的方向包括大规模比较研究、MSCs的高级表征以及个性化采集策略的开发。最终，研究结果表明，优化BMH部位可显著影响基于MSC的膝关节OA治疗的质量，提高其临床效用和患者预后。
