Abstract
BackgroundLow aspiration volumes have been recommended to allow for higher concentrations of progenitor cells during bone marrow harvesting. However, these guidelines then require multiple aspiration attempts in order to maximize cellular yield. The purpose of this study was to investigate the effect of a single, high-volume aspiration with four consecutive aliquots on the number of nucleated cells (NCs) and colony-forming units (CFUs) in concentrated bone marrow aspirate (cBMA) taken from the proximal humerus.MethodscBMA was taken from the proximal humerus of patients undergoing arthroscopic rotator cuff surgery. Four 12-mL double syringes were used consecutively from a single trocar to obtain four 10 cc aliquots. Each then underwent centrifugation to create a fractionated layer rich in nucleated cells. Following cellular separation, NCs were counted and CFUs were evaluated after incubation of 7–10 days. Cellular comparisons between each aliquot were performed along with their interaction with patient age and sex.ResultsTwenty-nine patients (55.9 ± 4.6 years) were included in this study. The number of NCs and CFUs showed significant differences between the four aliquots of aspirate, with the first 10 cc aliquot providing the highest amount (p < 0.001, respectively). No significant differences were found between the sum of the three sequential aliquots compared to the initial 10 cc sample. There were no significant differences between male and female patients (p > 0.05). Increasing age resulted in no significant decrease in the number of NCs and CFUs across the four consecutive aliquots (p > 0.05).ConclusionIn conclusion, while the initial aliquot provided the greatest number of nucleated cells and cultured CFUs, the addition of each sequential volume aspirate yielded similar amounts in total. This demonstrates the potential effectiveness of obtaining of higher volume aspirates from the proximal humerus during rotator cuff repair.
Highlights
Low aspiration volumes have been recommended to allow for higher concentrations of progenitor cells during bone marrow harvesting
After 5 min of centrifugation, the average volume of the concentrated layer of bone marrow aspirate (BMA) showed no significant difference between the four consecutive aliquots of aspirate (Fig. 1a)
There were significant differences found in nucleated cell count between the four aliquots of bone marrow aspirate (Fig. 2)
Summary
Low aspiration volumes have been recommended to allow for higher concentrations of progenitor cells during bone marrow harvesting. These guidelines require multiple aspiration attempts in order to maximize cellular yield. The purpose of this study was to investigate the effect of a single, high-volume aspiration with four consecutive aliquots on the number of nucleated cells (NCs) and colony-forming units (CFUs) in concentrated bone marrow aspirate (cBMA) taken from the proximal humerus. The authors found that smaller samples may contain a higher concentration due to larger volumes becoming diluted with peripheral blood [8]. Aspiration techniques using multiple aspirations of smaller volumes in order to limit dilution with peripheral blood would ensure a higher concentration of CTPs [5, 8, 9]
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