BMAC injections

BMAC (Bone Marrow Aspirate Concentrate) is a form of biologic treatment using a patient’s own body (concentrated bone marrow sample) to minimize joint pain and inflammation, as well as enhance healing and recovery. It is more involved than PRP, as the harvest site for bone marrow is the posterior superior iliac spine (back of the pelvic bone). After local anaesthesic, a specialized needle is inserted onto the pelvis and bone marrow is aspirated. This is concentrated using a specialized centrifuge to isolate the layer rich in bone marrow and stem cells. This concentrated sample is then injected into the treatment site under ultrasound guidance.

  • FAQ

What is Bone Marrow Aspiration Concentrate (BMAC) therapy?

BMAC therapy is a promising non-surgical regenerative treatment used to treat various orthopedic injuries, including mild to moderate osteoarthritis and tendon injures.

BMAC is a concentrate of regenerative stem cells obtained from a patient's own bone marrow. Dr. Rodriguez-Elizalde removes a small amount of bone marrow and spins it in a specialized centrifuge in order to generate a powerful concentrate that is injected into the injured area.

In the past, these types of cells were often very difficult and expensive to obtain from the body, and not approved by Health Canada.

With recent medical advancements and approvals, the cells can be easily obtained and the procedure can be done with minimal discomfort by a simple office procedure. The whole procedure takes about 60-90 minutes.

How does BMC therapy work?

While similar to Platelet Rich Plasma (PRP) in its ability to harness the body's ability to heal itself through the aid of growth factors, BMAC also utilizes regenerative cells that are contained within a patient's own bone marrow. The marrow contains a rich reservoir of "pluripotent" stem cells that can be withdrawn from the patient's pelvis bone and used for the procedure. Unlike other cells of the body, stem cells are "undifferentiated", meaning they are able to replicate themselves into various types of tissue.

When an injury process occurs, the usual number of regenerative cells needed for tissue regeneration is often inadequate. With BMC, the concentration of regenerative cells provides a more robust healing of the damaged tissue and aids in growth and repair by accelerating the body's natural healing mechanism.

While the full benefits of BMC are still unknown, it has been shown to reduce swelling, relieve pain, and enhance healing of articular cartilage and bone.

Does the Procedure Hurt?

While there is some slight discomfort, most patients tolerate the procedure very well and with minimal pain. The procedure is done under local anesthesia to minimize any discomfort.

Post-injection soreness at the injection site is sometimes present because of an inflammatory response caused by BMC therapy. This soreness usually resolves on its own within a few days after the injection.

It is important that anti-inflammatory medications such as Ibuprofen, Naproxen and Aspirin be avoided following treatments because these medicines may block the effects of the intended healing response facilitated by the post-injection inflammation. It is acceptable to use pain medication such as Tylenol, and in some cases a prescribed pain reliever, which does not have anti-inflammatory properties, to control discomfort as needed.

BMAC vs FAT derived Stem cells?

Many centers are offering “stem cell” injections, and are harvesting them from fat. Fat by definition has more stem cells than bone marrow – so why not use it?

First, unlike Bone Marrow, it is difficult to “extract” stem cells from fat. The bulk of the literature surrounding the use of “fat stem cells” involves its partial digestion or manipulation, which can be a lengthy process. Moreover, in Canada, the “manipulation” of stem cells is not approved.

There is more medical literature supporting the use of BMAC vs “fat stem cells” – both have been shown to work, but when deciding on a system, it was felt to be the safest, effective and comprehensive mode to deliver Stem Cells today.

BMAC vs FAT derived Stem cells?

Many centers are offering “stem cell” injections, and are harvesting them from fat. Fat by definition has more stem cells than bone marrow – so why not use it?

First, unlike Bone Marrow, it is difficult to “extract” stem cells from fat. The bulk of the literature surrounding the use of “fat stem cells” involves its partial digestion or manipulation, which can be a lengthy process. Moreover, in Canada, the “manipulation” of stem cells is not approved.

There is more medical literature supporting the use of BMAC vs “fat stem cells” – both have been shown to work, but when deciding on a system, it was felt to be the safest, effective and comprehensive mode to deliver Stem Cells today.

How is BMAC done?

The process is a simple 60-90 minute procedure done by Dr. Rodriguez-Elizalde himself. The pelvis is landmarked with use of an ultrasound machine, and adequately frozen and cleaned. Bone marrow is extracted from the back of the patient's pelvis from an area called the posterior iliac crest with the use of a special cannula.

A syringe collects the bone marrow, after which it is filtered and spun in a special centrifuge. The concentration of stem cells and healing components, collectively known as the bone marrow concentrate, are reintroduced to the injured area under an ultrasound guided injection. This is combined with PRP at the time of injection

Once introduced at the site of injury, it is theorized that the platelets release growth factors that tell the regenerative cells what to become, thereby initiating the regenerative response.

How quickly can I get back to my regular routine?

For the first 2-7 days, swelling and discomfort are typical in the injected area. By the end of the first week, these symptoms usually begin to resolve and physical therapy is started to optimize BMC effects and facilitate recovery. Patients have responded to BMAC treatment at varying timeframes.

Are there any contraindications (i.e. exclusion criteria) that would inhibit someone from getting BMC?

Bone marrow derived cancer (such as lymphoma), non-bone marrow derived cancer or metastatic disease (should be checked with your oncologist), and active systemic infections are all contra-indications. Blood thinning medications such as Coumadin must be discontinued and managed appropriately by your cardiologist or primary doctor prior to the procedure.

How long does it take BMC to "work"?

Most patients notice some level of improvement by 2-6 weeks following BMC. Increased stability and strength are typically reported along with the decrease in pain. A second level of benefits may be obtained between 6 weeks and 3months. Patients are encouraged to remain active with a functional rehabilitation program and strengthen surrounding muscles during this period.

How do I find out more, book a treatment?

By calling below, you will be connected to a clinic that performs BMAC injections. These treatments are not covered by insurance and are expensive. It is strongly suggested you meet with in consultation with Dr. Rodriguez-Elizalde to discuss suitability and treatment before booking anything. A referral form can be found here for your family doctor.
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