Abstract
The purpose of this study was to quantify the stem cell and growth factor (GF) contents in the bone marrow aspirate concentrate (BMAC) and platelet-rich plasma (PRP) prepared from whole blood using a protocol established in our laboratory. We examined 10 patients with osteonecrosis of the femoral head who were treated by autologous BMAC transplantation at our hospital between January 2015 and June 2015. We quantified CD34+ and CD31−CD45−CD90+CD105+ cells in BMAC and PRP by flow cytometry. Additionally, we measured various GFs, that is, basic fibroblast growth factor (b-FGF), platelet-derived growth factor-BB (PDGF-BB), vascular endothelial growth factor (VEGF), transforming growth factor-β1 (TGF-β1), and bone morphogenetic protein-2 (BMP-2) in BMAC and PRP using enzyme-linked immunosorbent assays and statistical analyses. CD34+ and CD31−45−90+105+ cells accounted for approximately 1.9% and 0.03% of cells in BMAC and no cells in PRP. The concentration of b-FGF was higher in BMAC than in PRP (P < 0.001), whereas no significant differences in the levels of PDGF-BB, VEGF, TGF-β1, and BMP-2 were observed between the two types of sample. BMAC had an average of 1.9% CD34+ and 0.03% CD31−45−90+105+ cells and higher levels of b-FGF than those of PRP.
Highlights
Bone marrow aspirate (BMA) is a mixture of aspirated BM cells, small tissue fragments, and venous sinus blood
We previously developed a treatment for osteonecrosis and nonunion using 30–40 ml of BMA concentrate (BMAC) produced without special instruments from 300–400 ml of BMAs harvested from the ilium and centrifuged [9,10,11,12,13,14]
It was previously demonstrated that CD34+ positive cells make up about 1% of the total number of mononuclear cells [22]; other investigators have reported that the proportion of nucleated cells in BMAC that were CD34+ was 1.0% ± 0.2% [23], which is consistent with our observations
Summary
Bone marrow aspirate (BMA) is a mixture of aspirated BM cells, small tissue fragments, and venous sinus blood (peripheral blood). BMAs have been used in orthopedic surgery for nonunion [4], the treatment of osteonecrosis (especially femoral head necrosis) and osseous defects, and bone lengthening [5,6,7,8]. The BMAC contained the platelet-rich plasma (PRP) formed just above the buffy coat layer. This fraction, which is a plasma fraction containing an abundance of platelets, has clinical applications in the field of orthopedic surgery as a regenerative treatment, primarily for sports injuries [15, 16]. Our earlier studies demonstrated the therapeutic value of PRP obtained
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