In vitroosteogenic capacity of bone marrow MSCs from postmenopausal women reflect the osseointegration of their cementless hip stems.
Age-related dysfunction of mesenchymal stromal cells (MSCs) is suggested as a main cause of altered bone repair with aging. We recently showed that in postmenopausal women undergoing cementless total hip arthroplasty (THA) aging, low bone mineral density (BMD) and age-related geometric changes of the proximal femur are risk factors for increased early migration and delayed osseointegration of the femoral stems. Extending these analyses, we have here explored how thein vitroosteogenic capacity of bone marrow MSCs from these patients reflects implant osseointegration, representing the patient'sin vivobone healing capacity. A total of 19 postmenopausal women with primary hip osteoarthritis (mean age 65 years, range 50-78) and well-defined bone quality underwent successful preoperativein vitroanalysis of osteogenic capacity of iliac crest bone marrow MSCs as well as two-year radiostereometric (RSA) follow-up of femoral stem migration after cementless THA. In patients with MSCs of low osteogenic capacity, the magnitude of cumulative stem subsidence after the settling period of three months was greater (p= 0.028) and the time point for translational osseointegration was significantly delayed (p= 0.030) compared to patients with MSCs of high osteogenic capacity. This study suggests that patients with MSCs of lowin vitroosteogenic capacity may display increased stem subsidence after the settling period of 3 months and thereby delayed osseointegration. Our study presents a novel approach for studying the biological progress of hip implant osseointegration and to verify the impact of decreased MSCs function, especially in patients with age-related dysfunction of MSCs and bone healing capacity.
Orthopaedic Research Unit, Department of Orthopaedic Surgery and Traumatology, University of Turku/Turku University Hospital, Turku, Finland.
Jessica J
JJ
Alm
Orthopaedic Research Unit, Department of Orthopaedic Surgery and Traumatology, University of Turku/Turku University Hospital, Turku, Finland.
Niko
N
Moritz
Orthopaedic Research Unit, Department of Orthopaedic Surgery and Traumatology, University of Turku/Turku University Hospital, Turku, Finland.
Hannu T
HT
Aro
Human mesenchymal stromal cells; Osseointegration; Osteogenic differentiation; Radiostereometric analysis; Total hip arthroplasty