Dataset Information

Use of Bone Marrow Aspirate Concentrate with Acetabular Labral Repair for the Management of Chondrolabral Junction Breakdown.

ABSTRACT: Despite advances in techniques for acetabular labral repair, strategies for mitigating or reversing damage to the chondrolabral junction do not yet exist. Cartilage repair techniques such as autologous chondrocyte implantation, matrix-induced autologous chondrocyte implantation, osteochondral autograft transfer, microfracture, and bone marrow aspirate concentrate (BMAC) have all been suggested to restore joint congruity and minimize further chondral deterioration. However, chondrocyte implantation techniques and osteochondral grafts are technically challenging in the hip because of its constrained nature, and many cell-based therapies have shown suboptimal results near the chondrolabral junction because of the increased shear forces at the peripheral acetabulum and increased stress at the weight-bearing region of the joint. By using BMAC to augment labral repairs and coat chondrolabral junction breakdown, we are able to introduce mesenchymal stem cells to peripheral acetabular tissue with little to no drawbacks, while avoiding donor-site morbidity, open procedures, and multiple surgeries. The purpose of this Technical Note is to describe a reproducible method for harvesting, processing, and applying BMAC to the chondrolabral surface of the hip during hip arthroscopy without the need for donor-site morbidity or increased labral repair time.

SUBMITTER: Stelzer JW

PROVIDER: S-EPMC6203226 | biostudies-literature | 2018 Oct

REPOSITORIES: biostudies-literature

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Use of Bone Marrow Aspirate Concentrate with Acetabular Labral Repair for the Management of Chondrolabral Junction Breakdown.

Stelzer John W JW Martin Scott D SD

Arthroscopy techniques 20180901 10

Despite advances in techniques for acetabular labral repair, strategies for mitigating or reversing damage to the chondrolabral junction do not yet exist. Cartilage repair techniques such as autologous chondrocyte implantation, matrix-induced autologous chondrocyte implantation, osteochondral autograft transfer, microfracture, and bone marrow aspirate concentrate (BMAC) have all been suggested to restore joint congruity and minimize further chondral deterioration. However, chondrocyte implantati ...[more]

PMID: 30377577

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Project description:Background: There is a need to identify and quantify mesenchymal stromal cells (MSCs) in human bone marrow aspirate concentrate (BMAC) source tissues, but current methods to do so were established in cultured cell populations. Given that surface marker and gene expression change in cultured cells, it is doubtful that these strategies are valid to quantify MSCs in fresh BMAC. Purpose: To establish the presence, quantity, and heterogeneity of BMAC-derived MSCs in minimally manipulated BMAC using currently available strategies. Study Design: Descriptive Laboratory Study. Methods: Five published strategies to identify MSCs were compared for suitability and efficiency to quantify clinical-grade BMAC-MSCs and cultured MSCs at the single cell transcriptome level on BMAC samples being used clinically from fifteen orthopedic patients and on one cultured MSC sample. Strategies included: 1) the guidelines by the International Society for Cellular Therapy (ISCT), 2) CD271 expression, 3) the Ghazanfari et al. transcriptional profile, 4) the Jia et al. transcriptional profile, and 5) the Silva et al. transcriptional profile. Results: ISCT guidelines did not identify any MSCs in BMAC at the transcriptional level and only 1 in 9 million cells at the protein level. 9 of 12850 BMAC cells expressed the CD271 gene. Only 116 of 396 Ghazanfari genes were detected in BMAC, whereas no cells expressed all of them. No cells express all Jia genes, but 25 cells express at least 13 of 22. No cells express all Silva genes, but 19 cells express at least 8 of 23. Most importantly, the liberalized strategies tended to identify different cells and most of them clustered with immune cells. Conclusion: Currently available methods need to be liberalized to identify any MSCs in fresh human BMAC and lack consensus at the single cell transcriptome and protein expression levels. These different cells should be isolated and challenged to establish phenotypic differences. Clinical Relevance: This study demonstrated that improved strategies to quantify MSC concentrations in BMAC for clinical applications are urgently needed. Until then, injected minimally manipulated MSC doses should be reported as rough estimates or as unknown.

Dataset Information

Use of Bone Marrow Aspirate Concentrate with Acetabular Labral Repair for the Management of Chondrolabral Junction Breakdown.

Publications

Use of Bone Marrow Aspirate Concentrate with Acetabular Labral Repair for the Management of Chondrolabral Junction Breakdown.

Similar Datasets

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