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Properties of Biologic Scaffolds and Their Response to Mesenchymal Stem Cells

Knut Beitzel, Mary Beth McCarthy, Mark P. Cote, Ryan P. Russell, John Apostolakos, Daisy M. Ramos, Sangamesh G. Kumbar, Andreas B. Imhoff, Robert A. Arciero, Augustus D. Mazzoccadomingo

Arthroscopy: The Journal of Arthroscopic and Related Surgery

Volume 30, Issue 3 , Pages 289-298, March 2014

Purpose: The purpose of this study was to examine, in vitro, the cellular response of human mesenchymal stem cells (MSCs) to sample types of commercially available scaffolds in comparison with control, native tendon tissue (fresh-frozen rotator cuff tendon allograft).

Methods: MSCs were defined by (1) colony-forming potential; (2) ability to differentiate into tendon, cartilage, bone, and fat tissue; and (3) fluorescence-activated cell sorting analysis (CD73, CD90, CD45). Samples were taken from fresh-frozen human rotator cuff tendon (allograft), human highly cross-linked collagen membrane (Arthroflex; LifeNet Health, Virginia Beach, VA), porcine non–cross-linked collagen membrane (Mucograft; Geistlich Pharma, Lucerne, Switzerland), a human platelet-rich fibrin matrix (PRF-M), and a fibrin matrix based on platelet-rich plasma (ViscoGel; Arthrex, Naples, FL). Cells were counted for adhesion (24 hours), thymidine assay for cell proliferation (96 hours), and live/dead stain for viability (168 hours). Histologic analysis was performed after 21 days, and the unloaded scaffolds were scanned with electron microscopy.

Results: MSCs were successfully differentiated into all cell lines. A significantly greater number of cells adhered to both the non–cross-linked porcine collagen scaffold and PRF-M. Cell activity (proliferation) was significantly higher in the non–cross-linked porcine collagen scaffold compared with PRF-M and fibrin matrix based on platelet-rich plasma. There were no significant differences found in the results of the live/dead assay.

Conclusions: Significant differences in the response of human MSCs to biologic scaffolds existed. MSC adhesion, proliferation, and scaffold morphology evaluated by histologic analysis and electron microscopy varied throughout the evaluated types of scaffolds. Non–cross-linked porcine collagen scaffolds showed superior results for cell adhesion and proliferation, as well as on histologic evaluation.

Clinical Relevance: This study enables the clinician and scientist to choose scaffold materials according to their specific interaction with MSCs.