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Bone Marrow-Derived Cellular Therapies in Orthopaedics

Part I: Recommendations for Bone Marrow Aspiration Technique and Safety

Piuzzi, Nicolas S., MD1,2; Mantripragada, Venkata P., PhD1; Sumski, Alan, BS1; Selvam, Selvaanish, BS1; Boehm, Cynthia, BS1; Muschler, George F., MD1

doi: 10.2106/JBJS.RVW.18.00007
Review Articles
Supplementary Content
Disclosures

  • * Bone marrow is a valuable source of cells for cell-based therapies in orthopaedics.
  • * Bone marrow aspiration is most frequently performed from the iliac crest and has been reported to be a safe procedure, with a low complication rate in orthopaedics.
  • * The bone marrow aspiration site, technique, and subsequent processing have a profound effect on the concentration and prevalence of connective tissue progenitors. The iliac crest generally provides the highest yield and prevalence of connective tissue progenitors.
  • * Small aspiration volumes (1 to 2 mL each), using 10-mL syringes, and modifying the aspiration sites by 5 to 10 mm are recommended to optimize the yield of connective tissue progenitors during bone marrow aspiration.
  • * In clinical trials of cell-based therapies derived from bone marrow aspiration, the aspiration technique (site, needle, syringe, aspiration volume, and anticoagulant, if used) should be reported.

1Departments of Biomedical Engineering (N.S.P., V.P.M., A.S., S.S., C.B., and G.F.M.) and Orthopaedic Surgery (N.S.P. and G.F.M.), Cleveland Clinic, Cleveland, Ohio

2Instituto Universitario del Hospital Italiano de Buenos Aires, Buenos Aires, Argentina

E-mail address for N.S. Piuzzi: piuzzin@ccf.org

E-mail address for V.P. Mantripragada: mantriv@ccf.org

E-mail address for A. Sumski: aas136@case.edu

E-mail address for S. Selvam: sxs1340@case.edu

E-mail address for C. Boehm: boehmc@ccf.org

E-mail address for G.F. Muschler: muschlg@ccf.org

Copyright © 2018 by The Journal of Bone and Joint Surgery, Incorporated
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