BMAC Injections

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

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.

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 The marrow contains a rich reservoir of “pluripotent” stem cells that can be withdrawn from the patient’s pelvis bone and used for the procedure.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 tissues.

When an injury process occurs, the usual number of regenerative cells needed for tissue regeneration is often inadequate. With BMAC, 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 BMAC are still unknown, it has been shown to reduce swelling, relieve pain, and enhance healing of articular cartilage and bone.

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 and discomfort.

Post-injection soreness at the injection site is sometimes present because of an inflammatory response caused by BMAC 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.

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.

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.

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 BMAC effects and facilitate recovery. Patients have responded to BMAC treatment at varying timeframes.

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.

Most patients notice some level of improvement by 2-6 weeks following BMAC. 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 3 months. Patients are encouraged to remain active witha. functional rehabilitation program and strengthen surrounding muscles during this period.

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 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.