What is Bone Marrow Aspirate?
Bone marrow is the soft, cushiony tissue found in the center of your bones. In adults, bone marrow is where your red and white blood cells and plasma components are produced. Bone marrow aspirate is first drawn from the patient, then growth factors are separated. From the resulting concentrate, the product is harvested and injected locally in order to simulate the body’s natural healing response and bring the tissue to a healthy state.
Bone Marrow Aspirate Concentrate (BMAC) Therapy is a cutting-edge regenerative therapy used to treat various orthopedic injuries, including moderate to severe osteoarthritis, ligament tears, joint pain and soft tissue injures. BMAC is a concentration of regenerative stem cells obtained from a patient’s own bone marrow. In a simple outpatient needle aspiration procedure, our physician collects a small amount of the patient’s bone marrow and spins it in a centrifuge to produce a concentrated amount of healing cells to be injected into the injured area. In the past, these types of cells were very expensive and challenging to obtain from the body. With recent medical advancements, the process can be completed more easily with minimal discomfort.
How does it work?
BMAC is similar to Platelet Rich Plasma (PRP) in how it is able to harness the body’s ability to heal itself through the aid of growth factors, but it also utilizes special regenerative cells that are contained within a patient’s own bone marrow called “master” cells or pluripotent stem cells which are unlike any other cells in the body. These cells are able to self-renew, meaning they are able to replicate themselves into various types of tissue.
When injury occurs, the usual number of regenerative cells needed for tissue regeneration is often not enough. With BMAC, the high concentration of regenerative cells and direct injection to the area of concern, provides intensive healing of the damaged tissue and helps to repair by accelerating the body’s natural method of healing. While the full benefits are still not clear, BMAC has been known to reduce inflammation, relieve pain, and enhance the healing of cartilage and bone.
What is the process?
The process for extraction is relatively simple. With local numbing medication, bone marrow is extracted from the back of the patient’s hip bone.
A syringe attached to a long needle is used to suction from the posterior of the hip. Minimal discomfort is felt due to local anesthetic. The marrow sample is collected and transferred through a filter then placed in a centrifuge for high speed spinning, which separates the platelets and growth cells from the bone marrow sample. The concentration of stem cells and healing components, BMAC (Bone Marrow Aspirate Concentrate), is then reintroduced to the injured area by injection with assisted ultrasound guidance.
Once introduced at the site of injury, the platelets release growth factors that direct the regenerative cells , thereby initiating the healing response. The entire outpatient procedure takes approximately 2 hours and patients can go home the same day.
What can we treat?
Many joint conditions can be considered for treatment with BMAC. Based on the current research and our clinical experience, moderate to severe cases of osteoarthritis and severe tendon injuries show the most promising results.
Most patients only require a single BMAC treatment depending on the degree of the injury. However, in challenging cases, if a patient only experiences linited relief, they may consider a second BMAC injection months later. Each case is unique and must be evaluated as such.
For the first 2-3 days, swelling and discomfort are typically expected in the injected area. By the end of the first week, these symptoms usually begin to resolve and physical therapy is started to optimize BMAC effects and facilitate recovery. Patients have responded to BMAC treatment at varying time frames.
If you have bone marrow derived cancer (such as lymphoma), non-bone marrow derived cancer or metastatic disease, or an active systemic infection you would not be a candidate for BMAC. Blood thinning medications such as Coumadin must be discontinued and managed appropriately by your cardiologist or primary doctor prior to the procedure.
No. BMAC is still not covered by insurance companies at this time.
Most patients report increased strength, improved stability and a decrease in pain within 2-6 weeks following the BMAC procedure. Relief of symptoms may improve even further between 6 weeks and 3 months. Patients are encouraged to remain active with physical therapy to strengthen surrounding muscles during this time frame.
In general, PRP may be more appropriate for mild to moderate osteoarthritis or tendon injuries. BMAC may be reserved for more challenging cases such as moderate to severe osteoarthritis or when more potent effects are desired.