This study was recently published in Stem Cell Research & Therapy and formed the basis for the BoneFlo®+ Concept.
Background: During joint replacement, surgical vacuum suction guarantees a sufficient overview on the situs. We assume high concentrations of mesenchymal stromal cells (MSCs) on surgical vacuum filters. We compared the in-vitro proliferative and differentiation potency of cells from: (i) bone marrow (BM), (ii) cancellous bone (CB), (iii) vacuum filter (VF), (iv) cell saver filtrate reservoir (SF) in 32 patients undergoing elective total hip replacement.
Methods: Mononuclear cells (MNC) were isolated and cell proliferation and cell-forming-units (CFU) were measured. Adherent cells were characterized by flow cytometry for MSC surface markers. Cells were incubated with osteogenic, adipogenic and chondrogenic stimuli. Cells were cytochemically stained and osteoblastic expression (RUNX-2, ALP, and BMP-2) investigated via qPCR.
Results: Dependent on the source, initial MNC amount as well as CFU number was significantly different whereas generation time did not vary significantly. CFU numbers from VF were superior to SR, BM and CB. The resulting amount of MSC from the respective source was highest in the vacuum filter followed by reservoir, aspirate and cancellous bone. Cells from all groups could be differentiated into the three mesenchymal lines demonstrating their stemness nature. However, gene expression of osteoblastic markers did not differ significantly between the groups.
Conclusion: We conclude that surgical vacuum filters are able to concentrate tissue with relevant amounts of MSCs. A new potent source of autologous regeneration material with clinical significance is identified. Further clinical studies have to elucidate the regenerative potential of this material in an autologous setting.