Optimising mesenchymal stromal cell harvesting in orthopaedic surgery

Thesis

Musculoskeletal tissue is prone to age-related degeneration and to damage which heals poorly. Many current treatments are able to treat only the end stages of these conditions, such as the use of total knee replacements in osteoarthritis. Cellular therapies are seen as a potential source of effective treatments for the earlier stages of these conditions. Orthopaedic surgery has been at the forefront of cellular therapies with treatments such as microfracture and autologous chondrocyte implantation to treat chondral defects.

As the largest area of current cell therapy research, stem cells have become an area of high interest for developing novel treatments. Mesenchymal stromal cells (MSCs) have provided the basis of the majority of orthopaedic treatments because of the relative ease of obtaining them. Despite the development of a number of treatments using both freshly harvested MSCs and culture expanded MSCs there is still a large gap in our knowledge of the mechanisms of actions of these cells and the most appropriate locations for obtaining autologous samples.

This thesis seeks to examine the best source of MSCs for surgery around the knee, comparing the pelvis to the femur and tibia. It also seeks to determine if it is possible to improve the yield of MSCs using a simple modification of the standard method of aspiration.

Assessments of the yield of all cells and MSCs showed that the pelvis was the optimum source for MSCs in terms of cell numbers. There was also a large amount of inter-subject variation in the number of cells obtained. There was no difference in the functional abilities of cells from any location. Modification of the aspiration technique did not improve the cell yield.

Future work should focus on improving yields from the pelvis and investigate methods of overcoming the inter-subject variability in yields if standardised treatments are to be successfully developed.

Authors: Davies, B

• DOI: 10.5287/ora-qqpe8xm2y
• Type of award: DPhil
• Level of award: Doctoral
• Awarding institution: University of Oxford
• Subjects: Regenerative medicine; Orthopedics; Tissue engineering; Cartilage--Regeneration; Mesenchymal stem cells