One of the methods employed to improve healing of damaged tissues is the use of cellular based therapies. A number of regenerative medicine based strategies, from in vitro expanded mesenchymal stem cells (MSCs) to "one-step" procedures using bone marrow (BM) in toto (BM aspirate; BMA) or BM concentrate (BMC), have been developed. Recently, orthopedic researchers focused their attention on the clinical therapeutic potential of BMC and BMA for musculoskeletal regeneration. BMA is reported as an excellent source of cells and growth factors. However, the quality of BM harvest and aspirate is extremely technique-dependent and, due to the presence of megakaryocytes and platelets, BMA is prone to clot. BMA clot formation is usually considered a complication hampering the procedures on both BMC preparation and MSC expansion. Therefore, different protocols have been developed to avoid and/or degrade clots. However, from a biological point of view there is a strong rationale for the use of BMA clot for tissue engineering strategies. This descriptive systematic literature review summarizes preclinical and clinical studies dealing the use of BMA clot for orthopedic procedures and provided some evidence supporting its use as a cell based therapy for cartilage and bone regeneration. Despite these results, there are still few preclinical and clinical studies that carefully evaluate the safety and efficacy of BMA clot in orthopedic procedures. Thus, implementing biological knowledge and both preclinical and clinical studies could help researchers and clinicians to understand if BMA clots can really be considered a possible therapeutic tool.

中文翻译：

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骨髓抽吸凝块：肌肉骨骼组织再生的技术并发症还是明智的方法？

用于改善受损组织愈合的方法之一是使用基于细胞的疗法。已经开发了许多基于再生医学的策略，从体外扩增的间充质干细胞（MSCs）到使用骨髓（BM）注入（BM抽吸液； BMA）或BM浓缩液（BMC）的“一步法”程序。最近，骨科研究人员将注意力集中在BMC和BMA在肌肉骨骼再生方面的临床治疗潜力。据报道BMA是细胞和生长因子的极好来源。但是，BM收获和抽吸的质量非常依赖技术，并且由于存在巨核细胞和血小板，BMA容易凝结。通常认为BMA血块形成是一种并发症，妨碍了BMC制备和MSC扩增的程序。所以，为了避免和/或降低凝块，已经开发了不同的协议。但是，从生物学的角度来看，将BMA凝块用于组织工程策略是有充分理由的。这篇描述性的系统文献综述总结了将BMA凝块用于整形外科手术的临床前和临床研究，并提供了一些证据支持其作为基于细胞的软骨和骨再生疗法。尽管有这些结果，仍然很少有临床前和临床研究仔细评估BMA凝块在整形外科手术中的安全性和有效性。因此，实施生物学知识以及临床前和临床研究都可以帮助研究人员和临床医生了解BMA血块是否真的可以被视为可能的治疗工具。