Bone Marrow Aspirate Concentrate-Enhanced Marrow Stimulation of Chondral Defects

Table 1

Translational studies of BMAC-enhanced marrow stimulation for articular cartilage repair.

Animal model

Animal number

Defect location

Defect type

Defect size

Additional treatment

Nature of biomaterials

Source of bone marrow

Concentration performed?

Method of concentration

Volume per defect

Study groups

Follow-up

Evaluation; methods

Major findings

Ref.

Horse

12

Trochlear ridge

Full thickness chondral

15 mm diameter

Microfracture

n.a.

Sternum

Yes

BMA harvested from two sternal marrow spaces (each 35 ml). Mixed with preservative- free heparin

n.a.

(1) Microfracture

8 months

(1) Cytological and flow cytometry analysis

(1) No adverse reactions

[65]

BMA (60 ml) was centrifuged. Yield: 6 ml of BMAC

(2) Microfracture + BMAC

(2) MRI

(2) Improved cartilage repair in BMAC group

(3) Macroscopic scoring

(3) MRI: increased defect fill, improved lateral integration

(4) Histological; scoring

(4) More type II collagen, improved collagen orientation, more glycosaminoglycans in BMAC group

Goat

15

Intercondylar region of knee

Full-thickness chondral

4 mm diameter

Subchondral drilling

Hyalgan (HA)

Iliac crest

Yes

BMA was centrifuged (1900 rpm, 10 min., at 10°C). Mean yield: 4.4 ml (range, 4.0 to 6.0 ml) of BMAC

400 μl

(1) Subchondral drilling

6 months

(1) Macroscopic observation

(1) Macroscopy: similar between empty defects and both HA groups. HA + BMA group: almost complete, smooth surface in level with adjacent cartilage

[64]

(2) Subchondral drilling + i.a. HA

(2) Histological scoring

(2) Better histological score in HA + BMA group with more proteoglycan staining and improved lateral integration

(3) Subchondral drilling + i.a. HA+ BMA injection

BMA: bone marrow aspirate; BMAC: bone marrow aspirate concentrate; HA: Hyalgan (sodium hyaluronate); i.a.: intra-articular; n.a.: not available; Ref.: reference.