Device Based Arthroscopic Mechanical Release of synovial Mesenchymal stem cells and Autologous Platelet concentrate can induce chondrogenesis without culture expansion.-Towards one stage cartilage repair

Abstract

Background & Aim Synovial fluid contains resident mesenchymal stem cells (SF-MSCs) that are derived from the synovial membrane and may interact with superficial cartilage injury sites . We previously reported novel methodology for increasing the number of MSC in knee joints using synovial brushing and of platelet lysate (PL) as chondrogenic inducer [1, 2]. The purpose of this study was to evaluate autologous and allogenic PL as chondrogenic inducer and the chondrogenic potential of the mobilised MSCs without resort to in vitro expansion. Methods, Results & Conclusion SF-MSCs were derived from joint cavity of patients undergoing arthroscopy procedures.Autologous blood was processed through platelet concentrating device HemaTrate (HT) to produce platelets concentrate (PC). For the mechanical release of MSCs‘before’ and ‘after’ brusing samples of irrigation fluid were collected and MSCs numbers were evaluated CFU-F assay and flow cytomery.Standard chondrogenic assay was performed on uncultured and cultured synovial cells. Pellet cultures were maintained in complete chondrogenic media (CCM), DMEM+50% of autologous PC,50% Stemulate (allogeneic PL) or expansion media (control). Chondrogenesis was assessed by Glycosaminoglycan (GAG) and Toluidine blue staining. The HT device significantly concentrated platelets and WBCs by 6 P 0.5. Unculturedsynovial cells produced significantly more GAG when cultured in CCM or DMEM+50% autologous PC compared to control P Conclusion: Autologous PC can be used as chondrogenic inducer for uncultured SF-MSCs. Sufficient cells can be released mechanically to be subjected to chondrogenic induction with significant chondrogenic activity without the need of culture expansion. This suggests possibility of one stage arthroscopy procedures for cartilage repair.