Optimizing bone marrow harvesting sites for enhanced mesenchymal stem cell yield and efficacy in knee osteoarthritis treatment

Table 1 Cell characteristics of bone marrow from various anatomical locations

Anatomical site	Common use	MSC characteristics	Differentiation potential	Homing and engraftment potential	Therapeutic use
Iliac crest[5]	Most commonly used site for bone marrow harvesting due to its high yield and easy access	Robust proliferative capacity, multi-lineage differentiation potential. High expression of CD105, CD73, CD90, CD146, and CD271	Potent osteogenic differentiation; suitable for bone regeneration. High expression of alkaline phosphatase and osteocalcin	Higher due to the high expression of adhesion molecules like CD146 and CD271	Ideal for bone regeneration due to osteogenic potential may support hematopoiesis
Tibial bone marrow[6]	Alternative site for MSC harvesting, especially for knee OA treatment	Potentially enhanced chondrogenic differentiation. Higher expression of chondrogenic markers like Sox9 and aggrecan	Enhanced chondrogenic potential; produces glycosaminoglycans and type II collagen. Suited for cartilage repair	Potentially higher chondrogenic activity due to enhanced niche for cartilage repair	Better suited for cartilage regeneration in OA due to chondrogenic differentiation potential
Femoral bone marrow[46]	Commonly accessed during orthopedic procedures such as total knee arthroplasty	High osteogenic potential, expressed higher levels of Runt-related transcription factor-2 and bone sialoprotein but lower proliferation rates compared to iliac crest	Superior osteogenic potential, higher mineralization capacity. High calcium deposition during osteogenic differentiation	Lower proliferation rates but high osteogenic commitment	Best suited for bone repair applications like non-union fractures or large bone defects

MSC: Mesenchymal stem cell; OA: Osteoarthritis.