Bone marrow is a soft, spongy tissue found in large bones. There are two types of bone marrow – red bone marrow and yellow bone marrow. Red bone marrow contains hematopoietic stem cells (HSC’s) which mature into red blood cells, white blood cells and platelets. Yellow bone marrow contains MSC’s which mature into connective tissues.
Bone Marrow Aspirate Concentrate (BMAC) is a non-surgical, minimally invasive, regenerative treatment that harnesses the natural ability to heal the body through the assistance of biological growth factors. BMAC utilises the regenerative mesenchymal stem cells collected from bone marrow to aid in the acceleration of healing moderate to severe osteoarthritis and tendon injuries.
Mesenchymal stem cells (MSCs) are a multipotent subgroup of stem cells which can develop into chondrocytes (cartilage cells), osteoblasts (bone cells), tenocytes (tendon cells), fibroblasts (ligament cells), and connective tissues. Yellow bone marrow derived mesenchymal stem cells (BMSCs) display a higher osteogenic (bone formation) and chondrogenic (cartilage formation) capacity compared to MSCs derived from adipose tissue which have a greater adiogenic (fat formation) capacity. MSCs and BMSCs display tissue-specific differentiation abilities, but with significant variation between donors.
At an injury site BMSCs secrete very high concentrations of tissue and cell specific targeting substances that support, maximize and direct self-repair and regeneration. These secretions block excessive inflammation by modifying the immune response to block inflammatory pathways, produce anti-inflammatory macrophages and increase anti-bacterial activity to provide long-term pain relief.
Current conditions and injuries treated with BMAC
- Knee Osteoarthritis
- Torn Meniscus
- Patellar Tendinopathy
- Quadriceps Tendinopathy
- Ligament Sprains or Tears (MCL, LCL and ACL)
- Hip Osteoarthritis
- Hip Labral Tears
- Greater Trochanteric (Hip) Bursitis
- Sacroiliac Joint (SIJ) Pain
- Piriformis Syndrome
- Iliotibial Band (ITB) Syndrome
- Achilles Tendinopathy
- Plantar Fasciitis
- Ankle Sprains/Ligament Injury
- Shoulder Osteoarthritis
- Rotator Cuff Tendinopathy
- Rotator Cuff Tears
- Labrum Tears
- Bicipital Tendinopathy
- Wrist/hand Osteoarthritis
- DeQuervain's Tenosynovitis
The BMAC procedure
Under sedation or local anaesthesia, bone marrow is aspirated (extracted) from the sacroiliac joint in the pelvis by making a small incision and inserting a hollow needle through the bone and into the marrow. A syringe is used to extract the liquid bone marrow.
The harvested bone marrow aspirate (BMA) contains a concoction of BMSCs, other beneficial progenitor cells and cytokines (growth factors). An approximate 0.001% of cells within BMA are BMSCs, so various filtration and centrifugal protocols are used to increase the concentration of BMSCs, and providing an effective environment for healing and regeneration. The final product, BMAC, is injected into the joint after sterile preparation.
The duration of the procedure is approximately 45 minutes, and the recovery time is relatively short due to the minimally invasive nature of the procedure. The BMAC procedure is simple, relatively painless and avoids the need for hospitalisation as there are no complications or adverse effects.
The injection offers:
- Pain relief
- Reduce swelling
- Increase joint function
- Improve condition of joint cartilage
Clinical considerations:
- Age: as we age the number of stem cells present in the bone marrow reduces, whereas the presence of fat is indifferent to age. The older the patient is, the less suitable the patient is for BMAC.
- BMI: another treatment, Micro-Fragmented Adipose Tissue (MFAT), requires the harvesting of fat from the patient’s thigh or stomach, however if a patient has very little fat, this is not possible and BMAC may be more suitable.
The difference between Mesenchymal Stem Cells (MSCs) and Bone Marrow Stem Cells (BMSCs)
Mesenchymal stem cells (MSCs) are a subgroup of stem cells. They are only capable of making a certain type of tissues such as bone, cartilage, muscle and fat.
Adipose (fat) derived mesenchymal stem cells (MSCs) can be harvested from multiple adipose tissue sites whereas bone marrow derived mesenchymal stem cells (BMSCs) can only be harvested from the bone marrow.
MSCs display higher proliferation rates and a greater adipogenic (fat cell formation) capacity than BMSCs. Whereas BMSCs display higher osteogenic (bone formation) and chondrogenic (cartilage formation) capacity compared to MSCs. MSCs and BMSCs display tissue-specific differentiation abilities, but with significant variation between donors. Age is considered to affect the properties of BMSCs.
Frequently asked questions
Within 2-6 weeks after the BMAC procedure most patients report an increase in stability and strength alongside a decrease in pain.
- Pain relief
- Reduced swelling
- Increase joint function
- Increased condition of joint cartilage
Most common risk: mild bruising around the BMAC harvest site.
Rare occurrences: anytime a needle is injected, even when drawing blood, there is a slight risk of infection, bleeding, tendon damage or nerve injury.
The first step is to contact our enquiry team by calling us or completing a contact form on our website. Once you have had your consultation, our specialist will recommend treatment which may include BMAC, Micro-Fragmented Adipose Tissue (MFAT), Monocytes, PRP Therapy, nSTRIDE or pain-relieving injections.
Clinical evidence
Clinical outcome of autologous bone marrow aspirates concentrate (BMAC) injection in degenerative arthritis of the knee
Autologous Bone Marrow Concentrate-Clinical Efficacy in the Treatment of Knee Osteoarthritis
Efficacy and Safety of Bone Marrow Concentrate for Osteoarthritis of the Hip; Treatment Registry Results for 196 Patients
Autologous bone marrow concentrate intradiscal injection for the treatment of degenerative disc disease with three-year follow-up
- Read more clinical evidence here