Bone marrow aspirate concentrate (BMAC), is the fluid component of bone marrow that has been removed from the body and put through a process that concentrates the stem cells and growth factors. It is used as a non-surgical regenerative procedure, sometimes referred to as stem cell therapy, to accelerate healing, especially in cartilage and joints.
BMAC is an autologous therapy, which is defined as taking an individual’s own cells or tissue, removing them to be processed outside of the body, and then reintroducing them back into the same person. Not only does using bone marrow aspirate concentrate take advantage of the body’s own inherent healing potential, but, because it comes from the individual’s own bone marrow, like platelet-rich plasma, another non-surgical regenerative procedure which increases the concentration of growth hormones in plasma, BMAC is unlikely to produce negative side effects or initiate a response from the immune system.
When Is Bone Marrow Aspirate Concentrate Used?
Bone marrow aspirate concentrate is typically used for orthopedic injuries that may benefit from a more highly concentrated mixture of regenerative cells to aid in the repair and growth of damaged tissue. Many experts believe that BMAC has the potential to reduce inflammation, as well as accelerate the formation of new tissue.
Some of the areas in which bone marrow aspirate concentrate is being used include:
- Bone fractures that have failed to grow back together
- Slow-healing wounds
- Osteonecrosis (bone death)
- Joints already affected by osteoarthritis
- Delaying the development and progression of arthritis
- Improving tendon function
An area where BMAC is showing particular promise is with cartilage damage. Cartilage is a connective tissue that plays the important role of acting as a cushion to keep bones from rubbing together. It is found in joints throughout the body. Despite the fact that cartilage is tough, as well as flexible, and designed to withstand a great deal of force and pressure, it can be damaged. Cartilage is also a prime target for the age-related degenerative damage of osteoarthritis.
Not only can damage and loss of cartilage be painful, but it can also negatively affect the quality of life due to diminished mobility. Non-surgical procedures, like bone marrow aspirate concentrate, for accelerating cartilage healing are a welcome addition to treatment options.
Why Bone Marrow?
When we are born, all of our bones contain bone marrow, which is the soft, spongy tissue inside bones. This is where the red blood cells, white blood cells and platelets are produced. On average, there are more than 220 billion new blood cells created in the bone marrow each day. By the time we become adults, new bone marrow cells are only being produced inside the bones of the skull, breast, shoulders, ribs, hips, and spine.
The bone marrow in the spine and hip contains the richest concentration of bone marrow cells. It is the iliac crest, which is one of the bones in the pelvis, where bone marrow cells are taken for bone marrow aspirate concentrate. This area is a common source for obtaining mesenchymal (adult) stem cells, progenitor cells, which are descendants of stem cells that have become more specialized, and other cells associated with growth factors.
All of these cells are believed to aid the healing process, especially once they have become more concentrated. Mesenchymal stem cells (MSCs) are the body’s active healing agents and they are at the heart of the blood marrow aspirate concentrate process. This is due to their ability to self-replicate and their potential for reducing inflammation, combating cell death, being able to differentiate into specialized cells, particularly bone and cartilage, and recruit other cells with healing properties to the site of an injury.
The Bone Marrow Aspirate Concentrate Process
Bone marrow aspirate concentrate is obtained by your physician drawing a sample of bone marrow, usually from the region of your pelvis known as the iliac crest. The aspiration process consists of a trochar, which is a three-sided cutting instrument that also has a tube for collecting the sample, being inserted into the site, and withdrawing the bone marrow fluid.
Once the sample is removed, it is filtered and placed into a centrifuge where the stem cells, platelets, and growth factors will become concentrated. What is now the bone marrow aspirate concentrate will be transferred into a sterile syringe and injected back into the same individual at the area of the body that is being targeted for treatment.
The BMAC procedure is typically done on an outpatient basis, with the patient being sedated.
What to Expect Following the Procedure
For most individuals, it is normal to expect some soreness in the area of the extraction. This should only last for a few days. With regard to the issue being treated, many patients experience improvement within the first couple of months following the BMAC procedure. Outcomes will depend on each individual’s condition, but reports include decreased pain and discomfort, as well as an increase in strength and stability.