Bone Marrow Aspirate Concentrate (BMAC)

Bone marrow is a soft, spongy tissue found in the center (medullary cavities) of bones. It plays a vital role in the body as it contains stem cells that produce most of the body's blood and immune system cells. It also contains mesenchymal stem cells that can form cartilage, muscle, fat, and bone. In the orthopedic setting, bone marrow is a source of regenerative cells used to enhance healing and recovery in musculoskeletal disorders.

Bone marrow aspiration is a procedure to withdraw bone marrow fluid, most commonly from the back of the hip (pelvic) bone, using a needle. BMAC therapy involves concentrating the bone marrow's stem cells, proteins and growth factors via centrifugation and/or flow cytometry, then injecting this concentrate into injured tissue. The stem cells in bone marrow differentiate into progenitor (regenerative) cells, which are able to make new cells where damaged cells once were. The reactions between growth factors and proteins in bone marrow reduce pain and inflammation by promoting tissue repair and functionality. Using BMAC therapy allows us to providing a natural, biological alternative for helping our patients manage orthopedic injuries.

Bone marrow is taken (aspirated) from the posterior superior iliac spine (PSIS) during the BMA procedure. The PSIS is part of the iliac crest on the pelvis. We use this location because of it's superficial position, which makes it an accessible and safe donor sit. For the procedure, you will be in a prone (belly down) position. The PSIS is identified and confirmed with ultrasound guidance to improve accuracy, as it serves as a "table" rather than a single point, providing a stable and thick bone area for aspiration.

The treatment is performed in a single outpatient session, allowing our patients to benefit from their body’s innate healing potential, without major surgery or downtime. The procedure is performed in our office, under local anesthesia with a small needle inserted into the bone to aspirate marrow. Most patients report some burning and stinging with injection of the local anesthesia. Patients may feel brief pressure sensations during aspiration, though this is not typically described as painful. Most patients manage mild post-procedure discomfort with ice and acetaminophen.​

The entire visit is for your bone marrow aspiration, BMAC processing and subsequent injection takes about an hour. Most of the time is allotted to the prep and processing. The aspiration itself takes only a few minutes. Once the aspiration is complete, it typically takes about 15 - 30 minutes to processing and injection.

BMAC is used for chronic joint pain, osteoarthritis, cartilage injuries, tendon and ligament injuries, and some bone injuries as well. There are few things it can't treat. It helps by promoting tissue repair through reactions between stem cells and growth factors, with the goals of improving strength and stability, and reducing pain.​

BMAC has minimal risks. We use your own bone marrow and cells, reducing risk of rejection or allergic reaction. Some soreness and swelling at the harvest site and injection area can occur, but this is usually very tolerable. Recovery involves resting the marrow harvest site, avoiding submersion for a few days, with gradual resumption of activities over a few days to a few weeks (depending on the intensity of the activity).​

Most patients require only one treatment, as BMAC targets the problem (not only the symptoms), addressing the root cause of pain. Some start to see improvement in pain and function within weeks, others within 1-2 months. A second injection may be considered if initial relief plateaus, though some patients elect to have repeat injections to perpetuate the positive response.