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A Prospective Comparison of 3 Approved Systems for Autologous Bone Marrow Concentration Demonstrated Nonequivalency in Progenitor Cell Number and Concentration

Hegde, Vishal MD*; Shonuga, Owolabi MD; Ellis, Scott MD; Fragomen, Austin MD§; Kennedy, John MD; Kudryashov, Valery; Lane, Joseph M. MD

doi: 10.1097/BOT.0000000000000113
Original Article

Objectives: To evaluate the efficacy of 3 commercially available systems: the Harvest SmartPReP 2 BMAC, Biomet BioCUE, and Arteriocyte Magellan systems. We compared the number and concentration of progenitor cells achieved both before and after centrifugation and the percentage of progenitor cells salvaged after centrifugation.

Methods: Forty patients, mean age 47 ± 18 years (range: 18–92 years, 19 male/21 female) were prospectively consented for bilateral iliac crest aspiration. The first 20 aspirations compared the Harvest and Biomet systems, and based on those results, the second 20 compared the Harvest and Arteriocyte systems. One system was randomly assigned to each iliac crest. Each system's unique marrow acquisition process and centrifugation mechanism was followed. Samples for analysis were taken both immediately before the marrow was put into the centrifugation system (after acquisition), and after centrifugation. The number of progenitor cells in each sample was estimated by counting the connective tissue progenitors (CTPs).

Results: The Harvest system achieved a significantly greater number and concentration of CTPs both before and after centrifugation when compared to the Biomet system. There was no difference in the percent yield of CTPs after centrifugation. There was no significant difference in the number and concentration of CTPs between the Harvest and Arteriocyte systems before centrifugation, but the Harvest system had a significantly greater number and concentration of CTPs after centrifugation. The Harvest system also had a significantly higher percent yield of CTPs after centrifugation compared with the Arteriocyte system.

Conclusions: The Harvest system resulted in a greater CTP number and concentration after centrifugation when compared with the Biomet and Arteriocyte systems and may thus provide increased osteogenic and chondrogenic capacity.

Supplemental Digital Content is Available in the Text.

*Department of Orthopaedic Surgery, University of California Los Angeles, Los Angeles, CA; and

Metabolic Bone Disease Service;

Foot and Ankle Service, and

§Limb Lengthening and Complex Reconstruction Service, Hospital for Special Surgery, New York, NY.

Reprints: Vishal Hegde, MD, Department of Orthopaedic Surgery, University of California Los Angeles, 10833 Le Conte Avenue, 76-143 CHS, Los Angeles, CA 90095 (e-mail: vhegde@mednet.ucla.edu).

Supported independently by our hospital's biologics review committee.

Presented at the Orthopaedic Trauma Association Annual Meeting, Minneapolis, MN, October 4–6, 2012.

S. Ellis is a consultant to Orthohelix. J. M. Lane is a consultant to Amgen, Zimmer, Grafty's, Bone Therapeutics SA, and Collplant, Inc, and has received grants from Eli Lilly, Novartis, Warner, and Chilcott. The other authors report no conflicts of interest.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions this article on the journal's Web site (www.jorthotrauma.com).

Accepted March 19, 2014

© 2014 by Lippincott Williams & Wilkins