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Table 3 Current mesenchymal stem cell transplantation protocols

From: Mesenchymal stem cells in the treatment of traumatic articular cartilage defects: a comprehensive review

Construct Transplantation protocol Advantages Disadvantages
BMDC-seeded scaffold[75],[80],[81],[89]-[91] Bone marrow aspiration, separation of nucleated cell population (BMDCs) by centrifugation, scaffold seeding, and implantation of BMDC-scaffold construct into the AC defect site Accessory cells/GFs create a natural microenvironment Low number of MSCs
One step procedure with aspiration and implantation in the same surgery Cells other than MSCs could promote immunorejection in allogeneic transplantation
MSC-seeded scaffold[38],[65],[72],[82]-[85],[88] Bone marrow aspiration, in vitro MSC isolation by adherence to plastic flasks, in vitro expansion of MSCs, scaffold seeding with MSCs, and implantation of MSC-scaffold construct into the AC defect site High MSC numbers are available due to expansion In vitro expansion may increase the risk of contamination
Isolation allows for purification of MSCs and potentially reduced likelihood of rejection in allogeneic transplant MSCs have the capacity to become bone without in vitro cueing prior to implantation (bone may be beneficial in osteochondral lesions)
Mid-range time consumption
Precultivated MSC-seeded scaffold[38],[66],[72] Bone marrow aspiration, MSC isolation by adherence to plastic flasks, expansion of MSCs in vitro, scaffold seeding with MSCs, in vitro precultivation in medium promoting chondrogenesis, and implantation of a cartilage tissue construct into the AC defect site High MSC numbers are available due to expansion In vitro expansion and cultivation may increase the risk of contamination
Chondrogenesis is stimulated Highest time and resource consumption
Increased mechanical stability of the implanted construct No clinical assessment to date
Early neo-tissue remodeling occurs in vitro and may be accounted for at the time of implantation
  1. AC, articular cartilage; BMDC, bone marrow-derived cell; GF, growth factor; MSC, mesenchymal stem cell.