Journal of Stem Cells Research and Therapy 1 J Stem Cell Res Ther, Vol.10 Iss.6 No:465 OPEN ACCESS Freely available online Research Article Correspondence to: Peter A. Everts, PhD, FRSM, Gulf Coast Biologics, Scientific and Research Department 4331 Veronica S. Schoemaker Blvd., Suite 4, Fort Myers, FL 33916, USA, Telephone: +1 239 848 9555, E-mail: peter@gulfcoastbiologics.com Received: September 29, 2020, Accepted: October 14, 2020, Published: October 21, 2020 Citation: Mautner K, Jerome MA, Easley K, Nanos K, Everts PA (2020) Laboratory Quantification of Bone Marrow Concentrate Components in Unilateral Versus Bilateral Posterior Superior Iliac Spine Aspiration. J Stem Cell Res Ther. 10:465. Copyright: © 2020 Mautner K, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Laboratory Quantification of Bone Marrow Concentrate Components in Unilateral Versus Bilateral Posterior Superior Iliac Spine Aspiration Kenneth Mautner 1,2 , Mairin A. Jerome 3 , Kirk Easley 4 , Katherine Nanos 5 , Peter A. Everts 6* 1 Department of Orthopedics, Emory University, Atlanta, Georgia, USA; 2 Department of Physical Medicine and Rehabilitation, Emory University, Atlanta, Georgia, USA; 3 Regenerative SportsCare Institute, New York, NY, USA; 4 Department of Biostatistics and Bioinformatics, Rollins School of Public Health Emory University, Atlanta, Georgia, USA; 5 Strive Physiotherapy and Sports Medicine, Toronto, ON, Canada; 6 Gulf Coast Biologics, Scientific and Research Department, Fort Myers, FL, USA ABSTRACT Mesenchymal Stem Cells (MSCs) from Bone Marrow Concentrate (BMC) have emerged as a promising treatment for degenerative musculoskeletal pathologies, such as Osteoarthritis (OA). Many aspiration techniques have been described in the literature with little consensus on optimal methodology. This study aimed to compare MSC quantity in unilateral versus bilateral Posterior Superior Iliac Spine (PSIS) bone marrow aspirate concentrations. Patients with unilateral knee OA seeking treatment with intraarticular BMC were recruited and randomized to a unilateral PSIS Bone Marrow Aspiration (BMA) or a bilateral PSIS BMA of equal total volumes. BMA and BMC samples underwent laboratory analysis of Colony Forming Unit-Fibroblasts (CFU-fs) as a marker for MSCs, for quantification of Total Nucleated Cell (TNC) count, and CD-34 positivity, in addition to other metrics. Data from 26 patients were analyzed. Mean total CFU-fs were 1.9 times higher in the bilateral group (n=13) versus the unilateral group (n=13); 42,912 versus 23,038, respectively (p=0.17). The median number of CFU-fs cultured from 1 ml of BMC in the bilateral cohort was 33% higher than the unilateral group (2477 versus 1860 CFU-fs/ml, respectively (p=0.23). Despite the difference in CFU-fs, the TNC counts were similar between the two groups. This descriptive study suggests a lower volume; multisite draw-technique for BMA increases the absolute number of CFU-fs, and therefore the correlated MSC count. Due to the limited statistical power, these data will need to be further evaluated with a larger patient dataset and correlated with patient outcomes data to determine clinical significance. Keywords: Bone marrow aspiration technique; Bone marrow concentrate; Quantitative analysis; Mesenchymal stem cell INTRODUCTION As life expectancy is increasing, musculoskeletal pain has emerged as a leading cause of years lost to disability worldwide [1]. Osteoarthritis (OA) is the most prevalent type of cartilage degenerative disease characterized by a complex interplay of mechanical injury, joint instability, and upregulation of matrix metalloproteinases and inflammatory cytokines, all leading to erosion of cartilage on articular surfaces [2]. These physical changes can lead to alterations in biomechanics and resultant pain, potentially of a debilitating nature. The prevalence of symptomatic knee OA is 6% in people over age 30 in the United States [3], 16% in patients over age 45 years, increases with age, and is more prevalent females [4,5]. Traditional care for pain related to OA has been to abate symptoms via conservative measures, including physical therapy, medications such as Non-Steroidal Anti-Inflammatories (NSAIDs), and corticosteroid injections [6]. With the exception of physical therapy, emerging evidence regarding the side effect profiles and risks associated with NSAIDs [7,8] and corticosteroids [9,10] make traditional conservative management strategies less than ideal for long-term management. As a last resort, surgical options such as partial or total knee arthroplasty can help, though surgery does come with increased risks and up to 12% of patients do not