Understanding musculoskeletal disease in the context of cellular microbiology and immunology is critical to choosing the right biologic for the right defect. Marrow CellutionTM provides new technology that incorporates a deep understanding of cell biology, the micro-environment, and immunology to optimize the power of autologous ortho-biologics in orthopedic care.
Marrow is the cornerstone of regenerative medicine because:
- The body’s natural response to any injury, acute or chronic, trauma or surgical, is to mobilize cells from the marrow space to the site of the defect through a process called vasculogenesis
- Positive clinical results are linked to the number of cells that migrate from marrow to a defect through the process of vasculogenesis
- The ability to mobilize cells from marrow to the site of a defect declines with age
- Mechanically aspirating marrow and transplanting it to a defect exactly mimics and supplements the body’s response to injury, a response that declines with age
- Tissue repair is an immune system regulated process and marrow cells are the engine or your immune system.
Specifically related to orthopedics:
- Cells grow bone. Marrow CellutionTM gives you more marrow cells while minimizing peripheral blood
- Your biologic should contain BMP and Stem Cells, why compromise. Granulocytic cells from a marrow aspirate are very rich sources of VEGF that up regulates the production of BMP-2 by endothelial progenitor cells, also found in marrow aspirate.
- Your bone graft should contain some autogenous bone harvested with minimal morbidity but with maximum cellular benefit. Bone cores taken with the Marrow CellutionTM Bone Core Device
- do not create post-operative complications because the diameter of the dowel is narrow. Several cores can be taken per procedure using the same device.
- do not disrupt the highly-organized living tissue structure to include the vascular micro- environment of the sample.
- Spanning a defect with these cores creates a healing environment that is similar to a fracture. Once an anastomosis is established to the dowel, the blood supply of the entire column is established. Marrow aspirate is highly angiogenic.
Bone Cores and marrow can be delivered over a working channel that includes a second marrow aspiration needle or arthroscopically. This technique allows for what was once an open procedure to be performed percutaneously. Combining marrow aspirate and bone cores that are sourced and delivered over a working trocar takes the concept of minimal invasiveness to a new level.
Why Adipose: Collagen verses Fibrinogen
- Synovial fluid has elevated levels of plasminogen that degrades fibrinogen and prevents the natural bleeding that occurs inside a joint from forming a platelet fibrin scaffold. (i.e. A platelet fibrin clot).
- Without a scaffold for cells to migrate and adhere to, healing remains impaired.
- Adipose tissue is made of collagen that does not degrade in the presence of synovial fluid or plasminogen and has cells imbedded within its matrix
- Human Platelets release a fast-acting plasmin inhibitor but native levels of platelets are not able to counteract the high levels of plasminogen in the synovium.
The ideal therapy for tissue inside the joint should contain high levels of collagen from fat, and bone marrow that has high amounts of stem cells, megakaryocytes, platelets and white cells that release growth factors.