Cassano · Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA 2018 · prospective comparative laboratory study · n=29

Bone marrow concentrate and platelet-rich plasma differ in cell distribution and interleukin 1 receptor antagonist protein concentration.

Cited 222 times in the scientific literature.

Level 3 - non-randomized controlled study

Prospective comparative study of biological products derived from a single patient cohort without clinical efficacy endpoints.

PubMed 26831858 · doi:10.1007/s00167-016-3981-9 · record verified 2026-08-26

What was done

Bone marrow aspirate (BMA) and peripheral blood were collected from 29 patients undergoing orthopaedic surgery. BMA was processed into bone marrow concentrate (BMC) using two commercial systems (BMC-A and BMC-B). Peripheral blood was processed into platelet-rich plasma (PRP) using the BMC-A system. Samples were analyzed for colony-forming units, mesenchymal stem cell (MSC) surface markers by flow cytometry, cellular concentrations, and catabolic cytokines and growth factors (including TGF-β1, PDGF, IL-1ra, and IL-1β) via multiplex ELISA.

What was found

Colony-forming units increased significantly in both BMCs compared to BMA (p < 0.0001), with surface markers consistent with MSCs. Platelet counts, TGF-β1, and PDGF showed no significant difference between BMC-A and PRP, whereas leukocyte concentrations differed. IL-1ra concentration was significantly higher in BMC-A (13,432 pg/mL) compared to PRP (588 pg/mL; p = 0.0018). The IL-1ra/IL-1β ratio in all BMC samples exceeded the reported threshold to inhibit IL-1β.

Why it matters

This study shows that BMC provides markedly higher levels of the anti-inflammatory cytokine IL-1ra than PRP while maintaining comparable growth factor levels, providing biological rationale for biologic choice in musculoskeletal repair.

Limits

The study was a laboratory compositional analysis without clinical or functional outcome tracking. The sample size was modest (n = 29), and direct numerical comparisons between the two commercial BMC systems were not provided in the abstract.

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