Bone Marrow Aspirate(BMA)

Bone Marrow Aspirate

Overview

Here, we only provide cellular therapy derived from the patient’s own body in order to minimize the risk of allergic reaction or disease transmission. We are able to get your own cells from bone marrow aspiration which is a procedure that can be done in the office with minimal discomfort. The primary source of bone marrow we use is the posterior iliac crest. The bone marrow regenerates and multiple procedures can be done over time. After drawing out the bone marrow, the stem cells are then concentrated to create bone marrow concentrate (BMC) which can then be injected into an appropriate area on the same day. The BMC concentrating process takes approximately 20 minutes in the office.

We do not obtain stem cells from adipose tissue (fat) at this time. We are awaiting further FDA regulatory guidance on using adipose tissue and its derivatives for orthopedic indications. Experimental data has shown that doctors can increase the amount of stem cells obtained in a bone marrow harvest by drawing smaller volumes from multiple sites. Typically, we use 1 harvest sites at multiple depths and 10cc or less volume draws in order to maximize the number of stem cells we obtain in our same day procedures. Out technique has been peer reviewed, published, and separately validated

What happens after the BMC injection in the office?

Depending on the specific area being treated, crutches or upper body immobilization may not necessary. If immobilization is necessary then typically it can be stopped after 2 days. Most patients will have some soreness for up to 48 hours that should decreases. Patient may use Tylenol or other non-anti-inflammatory pain medications. NSAIDs and other anti-inflammatories should be avoided in the post-procedure period because they block the response that leads to healing. Patients should refrain from significant physical activity or sports activities for about a week after the procedure. Patients are re-evaluated every 4-8 weeks after the procedure to evaluate their progress and to make further treatment recommendations.

Some of the growth factors in BMC are listed below.

  • Platelet Derived Growth Factor (PDGF)
  • Fibroblast Growth Factor (FGF)
  • Vascular Endothelial Growth Factor (VEGF)
  • Interleukin 8 (IL-8)
  • Transforming Growth Factor Beta (TGF-b)
  • Insulin Like Growth Factor 1, 2 (IGF-1,2)
  • Epidermal Growth Factor (EGF)

Cellular therapy may be useful in the following clinical conditions

Tendinopathy

(Chronic tendonitis or partial-thickness tears)

  • Rotator cuff
  • Biceps
  • Golfers/Tennis elbow
  • Tendonitis around the thigh (Gluteus medius, hamstring, piriformis syndrome)
  • Patellar or quadriceps tendonitis
  • Tendonitis around the ankle (Peroneal, Tibialis posterior)
  • Achilles
  • Plantar fasciitis

Ligament Injury

  • Ulnar collateral ligament injury of the elbow
  • Medial collateral ligament injury of the knee

Degenerative Joint Disease

  • Hip osteoarthritis
  • Knee osteoarthritis
  • Ankle osteoarthritis
  • Shoulder osteoarthritis
  • Elbow osteoarthritis
  • Wrist osteoarthritis
  • Cervical, Thoracic and Lumbar osteoarthritis
  • Articular Cartilage Injury

Fracture Care

Delayed union or non-unions