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Bone Marrow Concentrate


Bone Marrow Concentrate (BMC)

Bone Marrow Concentrate is one of the important cell populations in the developing field of biological therapies.

Research has demonstrated the capacity of concentrated bone marrow stem cells to repair cartilage, bone and tendon, as well as blood vessels and capillaries (which is an essential element to soft tissue healing).

The bone marrow stem cells are not available to the general circulation, because they are kept in the bone marrow until they are signalled to leave. Thus in order to use these valuable repair cells, harvesting directly from the bone marrow is performed.

What is Bone Marrow Concentrate?

The bone marrow cavity in the ilium bone of the pelvis contains a source of multi-potent stem cells, platelets, growth factors, and other proteins responsible for tissue repair and regeneration. Through aspiration, a physician can obtain all of these cells from the bone marrow. Think about this; 15 million cells are replaced by the bone marrow in the blood every second!

For The More Technically Minded

Concentrated bone marrow contains enhanced levels of:

a) Bone Marrow-Mesenchymal Stem cells (BM-MS)
i) Cells for bone formation BM-MS cells decrease with age;
ii) Concentrating mimics the cell load and healing potential of young patients;
iii) Stimulate tissue healing

b) Endothelial Stem Cells for supporting blood vessels
i) Healing is impaired until the blood supply to tissue is restored;
ii) Converts directly to for capillaries(micro-vessels);
iii) Stimulate BM-MS cells; and
iv) Stimulated by and work in areas of low oxygen.

c) Hematopoietic Stem Cells for supplying nutrients
i) Forms blood cells;
ii) Cell-to-cell contact with BM-MS cells stimulate bone and cartilage formation

d) Platelets to modulate the regeneration process
i) Recruit bone marrow progenitor cells to regions of injury;
ii) Provide adhesion sites for stem cells; and
iii) Platelet-fibrin clot/network provides migration highway at the site of injury, that is they act as a scaffold for cells to adhere to.

e) Adhesion Molecules
i) Mediate cell to cell adhesion;
ii) Maintenance of tissue integration, wound healing, and cellular migration

When bone marrow is harvested from the ilium bone of the pelvis, and centrifuged in a device made for the purposes of concentrating the multi-potent cells from whole bone marrow, we have Bone Marrow Concentrate.

Research has demonstrated the capacity of concentrated bone marrow stem cells to repair cartilage, bone and tendon, as well as blood vessels and capillaries (which is an essential element to soft tissue healing).

The bone marrow stem cells are not available to the general circulation, because they are kept in the bone marrow until under certain tissue signalling conditions. In order to use these valuable repair cells, harvesting directly from the bone marrow is performed.
What Is The Clinical Procedure?

Most people rate this procedure at a 1-2/10 on a pain scale of 0(no pain)-10(extreme pain). This is contrary to the reputation that this procedure usually attracts.

To get the bone marrow, the harvesting is done from the ‘red’ bone marrow of the ilium bone of the pelvis. First a potent local anaesthetic is given to the harvest site. Next, a tiny incision is made under ultrasound guidance, a specifically designed needle is introduced into the bone marrow. The marrow is then drawn from the bone.

The marrow volume is collected in a filtering container, then passed into a sophisticated processing machine which separates and concentrates the various relevant cell populations from the bone marrow. The different cell populations to be separated from whole bone marrow are controlled by an infra-red sensing devices in the processing machine.

BMAC is used in more serious injury and may be used in combination with PRP. This is because the growth factors released by the PRP upregulate(turn up the acticvtiy) the stem cells.

One can also use BMAC/PRP with harvested fat cells, to increase the potency of the effect even more. Fat cells for this purpose are gathered by a process of mini-liposuction.

When Is BMAC Indicated?

BMAC is used for all the tendon, ligament and joint indications in which PRP is used, but where a higher degree of healing needs to take place; that is, in more severe injury, or in injury that is not adequately responding to PRP and other conservative modalities.

Research is continuously emerging on the repair capacity that BMAC has on intra-articular structures of the joint, that is cartilage and joint capsule, as well as on tendon and ligament repair.

Experience in this practice, (>800 joints treated by stem cell therapy to date) reflects most encouraging results.

For athletes with a single area of injury, we have developed a more time-efficient cost-efficient way of obtaining and processing stem cells, which makes this option more commonly available as a potent option for injury healing.

How Often Is BMAC Administered?

BMAC is usually performed once, then followed by a PRP treatment 1-4 weeks later to provide a growth factor ‘refresher’ to the healing process. BMAC can be performed a number of times if necessary, because the bone marrow recovers from harvest extremely quickly.