General PRP and Stem Cell Research

Platelet Rich Plasma (PRP) | Bone Marrow Aspirate Concentrate (BMC) | Stem Cell Research

Soft Tissue Injuries | Sports Injuries | Arthritis

Biopsy needle advancement during bone marrow aspiration increases mesenchymal stem cell concentration

Peters AE, Watts AE.
Front. Vet Science. March 2016.

The authors collected 2 bone marrow aspirates using two different techniques from 12 horses. The first technique was to aspirate BM from a single site with no needle advancement. The second technique was to aspirate BM from multiple sites within the same puncture site by advancing the needle 5mm 3 times, resulting in an aspiration from 4 sites. The needle advancement technique resulted in higher nucleated cell counts, CFUf, and total MSCs. For the single site technique the TNC count/ml assay averaged 14.4 X 10(6); for the multiple site technique, the TNC count assay averaged 20.9 X 10(6) and this increase was statistically significant. For the single site technique the CFU-f assay averaged 33; for the multiple site technique, the CFU-f assay averaged 51 and this increase was statistically significant.

Bone marrow concentrate and platelet-rich plasma differ in cell distribution and interleukin 1 receptor antagonist protein concentration.

Cassano JM, Kennedy JG, Ross KA, Fraser EJ, Goodale MB, Fortier LA.
Knee Surg Sports Traumatol Arthrosc. 2016, January.

This study with 29 patients compared bone marrow aspirate concentrate compositions from the Arteriocyte Magellan device and the Harvest Technologies device with the PRP composition from the Arterioctye Magellan device. The PRP and BMA-C from the Arteriocyte system was compared and there was an 11.8x increase in WBC in BMA-C, a 19x increase in neutrophils in BMA-C, and the platelet concentration was the same in the PRP and BMA-C.  The concentration of PDGF and TGFB  was the same in the Arteriocyte PRP and BMC products.  VEGF was increased the BMA-C by a factor of 4 compared to PRP in the Arteriocyte products.  The concentration of IL-Ira (Interleukin 1 receptor antagonist) was significantly increased in BMA-C over PRP and was above the level needed for a net inhibitory effect on the inflamatory IL1. In comparing the Arteriocyte and Harvest BMC products, they found that there was a significantly greater platelet concentration in the Arteriocyte product.  For CFUs, the Arteriocyte product averaged 41.4 and the Harvest product averaged 32.7 but the difference was NOT statistically significant.

Applying Stem Cells to Orthopedic Conditions.

Kelly FB, Porucznik M.
AAOS Now. 2014 June.

This article, published in an established, peer-reviewed orthopedic surgery journal, summarizes the current and potential benefits of using stem cells in orthopedic surgery.

The use of platelet-rich plasma for the treatment of osteoarthritis.

Jayabalan P, Hagerty S, Cortazzo MH.
Phys Sportsmed. 2014 Sep;42(3):53-62.

In this article the authors review the evidence for the use of PRP in the treatment of arthritis and the clinical outcomes pertaining to its use.

A systematic review of the use of platelet-rich plasma in sports medicine as a new treatment for tendon and ligament injuries.

Taylor DW, Petrera M, Hendry M, Theodoropoulos JS.
Clin J Sport Med. 2011 Jul;21(4):344-52.

Presently, PRP use in tendon and ligament injuries has several potential advantages, including faster recovery and, possibly, a reduction in recurrence, with no adverse reactions described. However, only 3 randomized clinical trials have been conducted.

Application of biologics in the treatment of the rotator cuff, meniscus, cartilage, and osteoarthritis.

Anz AW, Hackel JG, Nilssen EC, Andrews JR.
J Am Acad Orthop Surg. 2014 Feb;22(2):68-79.

Advances in our knowledge of cell signaling and biology have led to the development of products that may guide the healing/regenerative process. Therapies are emerging that involve growth factors, blood-derived products, marrow-derived products, and stem cells.

Muscle and Tendon Injuries: The Role of Biological Interventions to Promote and Assist Healing and Recovery.

Andia I, Maffulli N.
Arthroscopy. 2015 Jan 21. pii: S0749-8063(14)00942-6.

Given the heterogeneity in tendons and tendinopathies, currently, we are not able to decide whether PRP therapies are useful. Despite advances in PRP science, data are insufficient and there is a clear need to optimize protocols and obtain more high-quality clinical data in both tendinopathies and muscle injuries before making treatment recommendations.

Chondrogenic potential of human adult mesenchymal stem cells is independent of age or osteoarthritis etiology

Scharstuhl A, Schewe B, Gaissmaier C, Buhring HJ, Stoop R.

The authors examined stem cells derived from the femoral bone marrow of 98 patients with osteoarthritis.  All stem cells harvested could differentiate into chondrogenic lineage (cartilage cells).  They conclude that a therapeutic application of mesenchymal stem cells (MSC) for cartilage regeneration of osteoarthritis lesions seems feasible.

The Role of PRP in Articular Cartilage Injury and Disease.  Authors:  Brian Cole, MD,  Randy Mascarenhas, Brian Saltzman, Lisa Fortier