Bone Marrow Aspirate Concentrate (BMAC) is a regenerative therapy that uses a patient’s own bone marrow to promote healing. This treatment concentrates beneficial cells from the body, aiming to support natural tissue repair and regeneration. The process involves collecting bone marrow, typically from the pelvis, and preparing it for therapeutic use in various musculoskeletal conditions.
Understanding Bone Marrow Aspirate Concentrate
BMAC is a concentrated solution derived from bone marrow, a soft, spongy tissue found inside large bones. This concentrate contains a variety of cell types that contribute to the body’s natural healing processes. Among these are mesenchymal stem cells (MSCs), which are multipotent cells capable of differentiating into various tissue types, including cartilage, bone, fat, and muscle cells. BMAC also includes hematopoietic stem cells (HSCs), which are responsible for producing blood cells, and a rich array of growth factors.
Growth factors present in BMAC, such as platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF), and transforming growth factor-beta (TGF-β), stimulate cell growth, promote new blood vessel formation, and influence tissue repair. BMAC also contains platelets and various white blood cells, which contribute to its anti-inflammatory and regenerative properties. These cellular elements and growth factors work together to support self-repair and regeneration at an injury site.
How Bone Marrow Aspirate Concentrate is Prepared
The preparation of BMAC begins with a bone marrow aspiration procedure, performed in a sterile clinical setting. The most common site for aspiration is the posterior superior iliac spine, an area at the back of the hip bone. A healthcare provider inserts a hollow needle into the bone marrow cavity and uses a syringe to draw out a small volume of liquid bone marrow, known as the bone marrow aspirate.
After collection, the bone marrow aspirate undergoes processing to concentrate the beneficial cells. This usually involves centrifugation, where the aspirate is spun at high speeds in a specialized machine. This spinning separates components based on their density, isolating desired cells and growth factors from other elements like red blood cells. The resulting concentrated liquid, BMAC, is then ready for injection into the targeted area.
Medical Applications of Bone Marrow Aspirate Concentrate
BMAC is applied in various medical fields, primarily orthopedics and sports medicine. It is commonly used for conditions affecting joints, tendons, and bones. For example, BMAC can be considered for individuals with osteoarthritis, a degenerative joint disease, where it may help promote cartilage regeneration and reduce pain and inflammation in affected joints like the knee, hip, or shoulder.
The treatment also addresses various tendon injuries, such as rotator cuff tears, Achilles tendinopathy, and tennis elbow. Ligament injuries, including anterior cruciate ligament (ACL) tears, may also benefit from BMAC. BMAC can be used for bone defects, such as non-union fractures (fractures that are slow to heal), and in cases of avascular necrosis (the death of bone tissue due to lack of blood supply).
What to Expect During a Bone Marrow Aspirate Concentrate Procedure
Before a BMAC procedure, patients discuss their medical history and current medications with their doctor. Patients are often advised to stop certain medications, such as non-steroidal anti-inflammatory drugs (NSAIDs) and blood thinners, about a week prior to minimize bleeding. Arranging for someone to drive you home after the procedure is also recommended, as it is an outpatient procedure.
During the procedure, local anesthesia numbs the aspiration site, usually the posterior iliac crest of the pelvis, to minimize discomfort. A specialized needle is inserted to aspirate the bone marrow. The concentrated BMAC is then injected into the injured area, often guided by imaging techniques like ultrasound or fluoroscopy for precise placement. The entire process usually takes one to two hours, and most patients tolerate it well.
Important Considerations for Patients
Patients considering BMAC therapy should consult with a qualified healthcare professional to determine if it is a suitable option. Individual responses to BMAC can vary, so outcomes may differ. Discussing any allergies, bleeding disorders, or current infections with the doctor beforehand is advisable.
Following the procedure, patients are advised to avoid strenuous activities for a few days. Applying ice to the injection site and using over-the-counter pain relievers, such as acetaminophen, can help manage discomfort. It is recommended to avoid anti-inflammatory medications like NSAIDs for several weeks post-procedure, as they may interfere with the healing response. Gentle range of motion exercises may be recommended, and follow-up appointments are scheduled to monitor progress.