Autologous Bone Marrow Concentrate (BMAC)

Autologous Bone Marrow Aspirate Concentrate (BMAC) Therapy is performed with cells obtained from your own body, more specifically from the bone marrow. It is a new minimally invasive injection treatment used now a days often, that may enhances tissue repair and as such may provide some improvement and be an alternative option of care for  spine degeneration, other orthopedic conditions and sport injuries that had traditionally, invasive surgery as the only option of treatment.  

Of the modalities of orthobiologic medicine that are legal to use in the USA, this is the most advanced, the most promising and the most sophisticated of all. It is also the most involved and the most expensive. Still, if you compare it with a joint surgical procedure, or a spine surgery, its cost, risks, suffering and also the down time involved, it is minimal.

This procedure at our office is done under local anesthesia and maybe with some oral sedation if needed. You walk in and out in about one hour and a half. Unfortunately as with everything else in medicine including surgery or other treatments, it does not work for every one but for some it may provide improvement of their condition. However in a good number of the candidates you obtain good results. Yes, even over 50% improvement and at times complete relief of your pain. But it is also important to pick the patients correctly to obtain the best results. Those patients with a very advanced degree of degeneration, or certain types or injuries or conditions, they are not good candidates.

When considering these modern and advanced orthobiologic techniques you always need to remember that they show promise although more research is still needed.

In comparison, a joint replacement surgery is a traumatic major surgical procedure that requires a major anesthetic with all its possible complications and also requires a long rehabilitation period. Remember not all patients are good candidates for surgery, specially older patient with severe medical conditions such as severe coronary disease, severe emphysema etc. because of the risk involved.These patient may find relief with this kind of procedure without the risk of the surgery.  

Additionally and what is even worse, is the fact that after surgery you may still suffer from pain. Not all knee pain goes away after surgery in a good number of patients. Just ask around to friends that have had a joint replacement and get them to tell you about their experience.

If you would like to read about some of the issues faced with knee replacement surgery, please visit the blog section in this website and read the one titled "Facts about knee replacement" with all the references. Dont let them sell you a knee joint replacement as if it was like changing a part in a car, because it is not ! 

The actual   Cells used in this procedure are obtained from your own Bone Marrow by doing a bone marrow aspiration from the iliac crest (best) using a Jamshidi needle or other divise. You take the bone marrow aspirate and you centrifuge it to concentrate and separate the cells.

Additionally for this procedure sometimes we like to also draw about 60 CC of blood from a peripheral vein, usually an arm vein. We centrifuge this blood and prepare PRP or Platelet Rich Plasma, which has a high concentration of growth factors. These growth factors, when injected into the joint immediately after the BMAC cells, stimulate the growth of the cells. That is, we combine bone marrow aspirate concentrate (BMAC) with the Platelet Rich Plasma (PRP) and injected both into the joint or area we are treating in the patient. 

Nothing foreign is added and the cells are not modified in any way shape or form since that is not allowed in the USA at this time and would constitute the creation of a drug which is a highly regulated process.  We alway strive to stay within the strict guidelines of the FDA and we do not make any false claims. We exclusively use the Autologus Cells obtained from your own bone marrow to treat musculoskeletal conditions.

We do not use any of the many other products advertised out there such as amniotic fluid or cord blood products. They contain no live Stem Cells and have been know to transmit disease. 

When doing this procedure to treat for example the hip joint, the knee joint, the shoulder, the ankle, your spine etc., we always use fluoroscopy or ultrasound guidance for the injection to make sure we are depositing the orthobiologic material injected where it needs to go. Doing it blindly is never the way to go because you basically are guessing and can’t be 100% certain of where you are putting it.

A month after your initial procedure sometimes you will have a booster injection of Platelet Rich Plasma with its growth factors to further stimulate the growth of the cells we deposited there.

These procedures show promise but more research is needed. We want you to be well informed before you decide to have the procedure done and before you visit our office so you can ask the appropriate questions.  We want to encourage you to do a search on the web about autologous Bone Marrow Concenrate (BMC) therapy. Here is an extensive review article link but there are many others: https://www.nature.com/articles/s41536-019-0083-6