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Bone Marrow Aspiration Concentrate (BMAC)

Why use BMAC?

Often times when an injury occurs, the body’s ability to completely heal is inadequate due to an insufficient number of regenerative cells. Bone marrow contains cells that have the ability to improve circulation, decrease inflammation and regenerate healthy tendon, ligament, disc and cartilage.

With BMAC, the high number of concentrated regenerative cells provides a robust healing response to the damaged tissue and aids in accelerating the body’s natural healing mechanisms.

While the full benefits of BMAC are still investigational, clinical studies have demonstrated reduction in joint stiffness, relief of pain, and enhanced cartilage and bone healing.

What types of conditions are treated with BMAC?

Numerous conditions can be considered for treatment with BMAC. Based on current research and clinical experience, moderate to severe cases of osteoarthritis and severe tendon injuries show promising results.

  • Knee Pain – Osteoarthritis, Meniscus Tears, Chondromalacia Patella, Tendon Injuries, Ligament sprains or tears.
  • Hip Pain – Osteoarthritis, Hip Labrum Tears, SI Joint Arthritis, Gluteal tendon tears, Iliotibial Band (ITB) Syndrome
  • Shoulder – Osteoarthritis, Rotator Cuff Tendinitis, Tendonopathy, or Tears, Labrum Tear, Bicipital Tendinitis
  • Elbow Pain – Lateral Epicondylitis (Tennis Elbow), Medial Epicondylitis (Golfers Elbow), Osteoarthritis
  • Wrist/Hand Pain – Osteoarthritis, DeQuervain’s Tenosynovitis
  • Ankle & Foot Pain – Achilles Tendinitis or Partial Tears, Plantar Fasciosis, Ankle sprains/ligament injury

How does BMC therapy work?

While similar to Platelet Rich Plasma (PRP) in its ability to harness the body’s ability to heal itself through the aid of growth factors, BMAC also utilizes regenerative cells that are contained within a patient’s own bone marrow. The marrow contains a rich reservoir of “pluripotent” stem cells that, unlike other cells of the body, are “undifferentiated”. This means they are able to replicate themselves into tendon, bone, adipose or cartilage. More importantly, these cells stimulate your body’s ability to improve circulation, decrease excessive inflammation and regenerate healthy tissue.

What is the difference between PRP (Platelet Rich Plasma) and BMAC?

PRP contains many of the growth factors and proteins found in BMAC, however PRP does not contain the regenerative cells found in BMAC.
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 other conditions when a more potent healing response is required.

How is the treatment performed?

The process is relatively simple and generally requires one to two hours. The back of the hip is numbed with a local anesthetic. About four tablespoons of bone marrow is aspirated and then transferred into a centrifuge. Spinning separates and concentrates the cells which contain the stem cells and healing components, collectively known as the bone marrow concentrate (BMAC). This preparation is reintroduced into the injured tissues using ultrasound or X-ray guidance. Upon completion of the procedure, patients may go home the same day.

Is removing bone marrow or the injection procedure painful?

While there can be some slight discomfort, most patients tolerate the procedure very well and with minimal pain. The procedure is performed after using local anesthetic. Soreness at the injection site may occur because of an inflammatory response caused by BMAC therapy. Inflammation represents the first stage of healing and is necessary for your recovery. This soreness usually resolves on its own within a few days after the injection. It is important that anti-inflammatory medications such as Ibuprofen, Naproxen and Aspirin be avoided following treatments because these medicines may block the intended healing response. Tylenol or a prescription pain reliever may be used to control discomfort if needed.

Is BMAC therapy just a temporary band-aid?

Unlike cortisone shots that mask symptoms or damage cartilage and tendons, BMAC targets the root of the problem by attempting to heal the tissue completely.

How many treatments will I need?

Most patients require only a single BMAC treatment depending on the degree of the injury. However, in challenging cases, if a patient experiences significant but not complete relief, they may consider a second BMAC injection 2 to 3 months later.

How quickly can I get back to my regular routine?

For the first 2-3 days, swelling and discomfort are typical in the injected area. By the end of the first week, these symptoms usually begin to resolve and physical therapy is started to optimize recovery. Patients have seen improvements as early as one week or as late at as 8 weeks following BMAC therapy.

Are there any contraindications to having BMAC therapy?

Bone marrow derived cancers, such as lymphoma, non-bone marrow derived cancer or metastatic disease and active infection are all contra-indications. Blood thinning medications such as Coumadin must be discontinued and managed appropriately by your cardiologist or primary care doctor prior to the procedure.

Is BMAC covered by my medical insurance?

No. While there are currently several publications in peer-reviewed medical journals showing the positive effects of BMAC therapy on tendon, soft tissue, and cartilage injuries, BMAC is still considered investigational by insurance companies at this time.

Can the procedure be repeated?

The bone marrow cells in the pelvis are restored in 4 to 6 weeks, therefore repeat cell harvest is permitted. Most of our patients only require one treatment, but it can be repeated if necessary. This is in stark contrast to steroid injections or surgery that should not be repeated if possible.

What are the long term effects of BMAC therapy?

There is significant evidence that the benefits of BMAC therapy may last up to ten years or longer. Once the injured tissue is healed, pain should resolve unless there is another injury. Your body’s stem cells are attempting to heal you on a daily basis. It stands to reason that BMAC therapy works in the same manner. To date, there is no evidence that any increased long term risk to the patient’s health exists following BMAC therapy. In fact, we think you will be healthier.