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BMAC (Bone Marrow Aspirate Concentrate) Stem Cell Treatment Frequently Asked Questions

What is BMAC and how does it work?

Bone Marrow Aspirate Concentrate (BMAC) Therapy, though still considered experimental in nature, is currently the most commonly used regenerative therapy. Its primary use is currently for osteoarthritis, where it can slow the degenerative effects, reduce pain, and improve daily function. It can also help with healing in persistent/chronic tendon and soft tissue injuries.

While similar to PRP in its ability to harness the body’s ability to heal itself, BMAC also utilizes regenerative cells that are contained within a patient’s own bone marrow. The marrow contains a rich reservoir of not only regenerative cells (stem cells), but many other growth factors and signaling chemicals that stimulate healing. The regenerative cells provide a more robust healing of the damaged tissue and aids in growth and repair by accelerating the body’s natural healing mechanisms.

Bone marrow aspirate concentrate is a preparation of your own bone marrow that is spun in a centrifuge and concentrated. The bone marrow is harvested from a bone in your pelvis (back of the hip) under local anesthesia with lidocaine. The marrow is combined with an anticoagulant to keep it from clotting. It is then spun in a FDA-approved centrifuge to concentrate the stem cells. Stem cells work directly at the site of injury or degenerative issue to repair and heal the damage.

What can be treated with BMAC?

Many soft tissue injuries and degenerative or arthritic conditions can be helped with BMAC. Chronic joint pains and arthritis as well as chronic tendinitis are often targeted. The success depends on many factors which should be discussed with your doctor.

When would you use PRP versus BMAC?

In general, PRP may be more appropriate for mild to moderate arthritis and tendon injuries. BMAC may be reserved for more challenging cases, such as moderate to severe osteoarthritis or when more potent effects are desired, such as in the case of larger rotator cuff or other tendon tears.

How is BMAC delivered to the injured area?

The doctor may use ultrasound or fluoroscopy to provide guidance in injecting the BMAC into the injured area which may be a joint, tendon, ligament, or muscle.

Is the procedure painful?

The marrow harvest procedure is performed under local anesthesia with lidocaine. Ice and pressure are applied after the procedure. Most patients experience a few days of pain after the procedure that is usually easily managed with heat and acetaminophen or a prescription medication that your doctor may prescribe. It is recommended that the patient keep the harvest site for the bone marrow covered and avoid submersion for 48 hours. Ice can help with the pain at the harvest site.

How long before I can resume activity?

While it varies from patient to patient, usually activity can slowly resume after 2-3 days. Normal daily activity can typically begin with less pain at this time. Exercise can slowly resume at 2 weeks, cutting your distance and time by 50%. If you experience pain, you should stop.

When will I be able to go back to work/school after treatment?

Most patients are able to return to school or work the next day after treatment. Occasionally, we recommend you take off a day or two. Everyone is different and reaction to the treatment can vary.

What can be done to prepare for my BMAC injection?

A balanced diet, low in fat and high in protein as well as lots of water leading up to the procedure. You should avoid NSAIDs (non-steroidal anti-inflammatory medications) for 5 days prior and 4-6 weeks after. On the day of injection, wear comfortable clothing and bring a driver to drive you home after the procedure.

Is there anything that can prevent me from being a candidate for BMAC?

Individuals with anemia, low platelet counts, abnormal platelet function, ongoing or recurrent infections may not be able to have BMAC. If you are currently undergoing treatment for cancer or are pregnant or breastfeeding, you should discuss your situation with your physician and medical care team.

Blood thinning medications such as Coumadin must be discontinued and managed appropriately by your Cardiologist or Medical Care team prior to the procedure.

Are there adverse effects?

BMAC is quite safe and the main drawback is post-procedural discomfort. Occasionally, a patient may experience a mild fever, swelling of the injected area, body aches, and fatigue for up to 3 days. If you are concerned about a symptom, please call the office.

How many treatments will I need?

Our goal is 80-90% improvement in pain and function. We attempt to do this with as few injections as possible, but the number of treatments required depends on the patient and the severity of the problem. Occasionally, a PRP injection can be performed 8-12 weeks later, acting as a “booster” for further healing. This can be discussed with your doctor.

How long is the healing process?

While every patient is different, patients may see improvement in as soon as 6 weeks. However, damaged or abnormal collagen (connective tissue) typically takes 9-12 months to completely heal.

Bone Marrow Aspirate Concentrate (BMAC) Therapy, though still considered experimental in nature, is currently the most commonly used regenerative therapy. Its primary use is currently for osteoarthritis, where it can slow the degenerative effects, reduce pain, and improve daily function. It can also help with healing in persistent/chronic tendon and soft tissue injuries.

While similar to PRP in its ability to harness the body’s ability to heal itself, BMAC also utilizes regenerative cells that are contained within a patient’s own bone marrow. The marrow contains a rich reservoir of not only regenerative cells (stem cells), but many other growth factors and signaling chemicals that stimulate healing. The regenerative cells provide a more robust healing of the damaged tissue and aids in growth and repair by accelerating the body’s natural healing mechanisms.

Bone marrow aspirate concentrate is a preparation of your own bone marrow that is spun in a centrifuge and concentrated. The bone marrow is harvested from a bone in your pelvis (back of the hip) under local anesthesia with lidocaine. The marrow is combined with an anticoagulant to keep it from clotting. It is then spun in a FDA-approved centrifuge to concentrate the stem cells. Stem cells work directly at the site of injury or degenerative issue to repair and heal the damage.

Many soft tissue injuries and degenerative or arthritic conditions can be helped with BMAC. Chronic joint pains and arthritis as well as chronic tendinitis are often targeted. The success depends on many factors which should be discussed with your doctor.

In general, PRP may be more appropriate for mild to moderate arthritis and tendon injuries. BMAC may be reserved for more challenging cases, such as moderate to severe osteoarthritis or when more potent effects are desired, such as in the case of larger rotator cuff or other tendon tears.

The doctor may use ultrasound or fluoroscopy to provide guidance in injecting the BMAC into the injured area which may be a joint, tendon, ligament, or muscle.

The marrow harvest procedure is performed under local anesthesia with lidocaine. Ice and pressure are applied after the procedure. Most patients experience a few days of pain after the procedure that is usually easily managed with heat and acetaminophen or a prescription medication that your doctor may prescribe. It is recommended that the patient keep the harvest site for the bone marrow covered and avoid submersion for 48 hours. Ice can help with the pain at the harvest site.

While it varies from patient to patient, usually activity can slowly resume after 2-3 days. Normal daily activity can typically begin with less pain at this time. Exercise can slowly resume at 2 weeks, cutting your distance and time by 50%. If you experience pain, you should stop.

Most patients are able to return to school or work the next day after treatment. Occasionally, we recommend you take off a day or two. Everyone is different and reaction to the treatment can vary.

A balanced diet, low in fat and high in protein as well as lots of water leading up to the procedure. You should avoid NSAIDs (non-steroidal anti-inflammatory medications) for 5 days prior and 4-6 weeks after. On the day of injection, wear comfortable clothing and bring a driver to drive you home after the procedure.

Individuals with anemia, low platelet counts, abnormal platelet function, ongoing or recurrent infections may not be able to have BMAC. If you are currently undergoing treatment for cancer or are pregnant or breastfeeding, you should discuss your situation with your physician and medical care team.

Blood thinning medications such as Coumadin must be discontinued and managed appropriately by your Cardiologist or Medical Care team prior to the procedure.

BMAC is quite safe and the main drawback is post-procedural discomfort. Occasionally, a patient may experience a mild fever, swelling of the injected area, body aches, and fatigue for up to 3 days. If you are concerned about a symptom, please call the office.

Our goal is 80-90% improvement in pain and function. We attempt to do this with as few injections as possible, but the number of treatments required depends on the patient and the severity of the problem. Occasionally, a PRP injection can be performed 8-12 weeks later, acting as a “booster” for further healing. This can be discussed with your doctor.

While every patient is different, patients may see improvement in as soon as 6 weeks. However, damaged or abnormal collagen (connective tissue) typically takes 9-12 months to completely heal.