Ep. 9: BMAC

Hey everyone! It’s Dr. Jay Bowen and I am a board certified physiatrist who focuses on orthopedic issues and today I wanted to welcome you to episode 3 in our series called The Good, The Bad, and The Truth About Regenerative Medicine.

In the last two weeks I talked about PRP and MFAT - two of the most common procedures at NJRI. If you haven't seen these videos be sure to check them out as well as our series on knee injuries. Additionally, make sure you subscribe to our page so that you don’t miss out on any of our content! 

This week I will be talking about Bone Marrow Aspirate Concentrate or BMAC for short - can you tell we love our acronyms here? First, I’m going to explain what this procedure is, then I’ll share with you the good and the bad of the procedure. Alright, let’s get into it! 

When I mention BMAC to most of my patients, they’ve never heard of it before. This procedure involves taking your bone marrow and utilizing the regenerative powers of the bone marrow to help heal you. Think of this procedure as a supercharged version of PRP!

During the procedure, we use a needle to extract bone marrow from your pelvis near your buttocks. We use local anesthesia and medication to relax you and only take a small amount. Although hearing “bone marrow extraction” can be scary I promise this is not a super intensive procedure or that painful! After we collect the bone marrow, we process it in our lab room. 

The aspirated bone marrow is processed in a centrifuge to separate and concentrate the cells and other regenerative factors. This concentrated solution is known as BMAC.

Once the BMAC is ready, I inject it with guidance into the area needing treatment. Like all of the procedures I’ve talked about so far in this series, BMAC is powerful because it helps release YOUR intrinsic ability to heal. BMAC is most helpful for more severe injuries, such as the loss of joint cartilage you know as arthritis. 
The development and use of BMAC in regenerative medicine have evolved over several decades, drawing on advances in cell biology, orthopedics, and regenerative therapies. It all started in 1956 when the first successful bone marrow transplants for treating leukemia was done in New York. This laid the groundwork for exploring other uses of bone marrow cells. Throughout the 60s, doctors and scientists spent time researching the power of stem cells. In the last thirty years, techniques for aspirating bone marrow and concentrating its components began to improve.

Researchers began to explore the use of concentrated bone marrow aspirate in orthopedics and regenerative medicine, focusing on its potential to enhance healing and repair injured tissues. The use of BMAC in regenerative medicine gained traction as clinical studies demonstrated its potential benefits for treating conditions such as osteoarthritis, tendon injuries, and cartilage damage. Advances in processing technologies, including more efficient centrifugation methods and improved understanding of cell biology, have enhanced the yield of BMAC for treatments. Ongoing clinical trials and research continue to investigate the efficacy of BMAC for various conditions, refine protocols, and establish best practices.

Since BMAC, like many regenerative procedures are still relatively new, this is another area where the data collected by DataBiologics is of the utmost value! As our research improves, so will our treatment techniques and overall clinical outcomes. Alright,  now let's dive into the good, the bad, and the truth about BMAC!

The Good - one of the biggest advantages of BMAC is its ability to leverage your body's own healing power. Because we use your own bone marrow, there's no risk of rejection and minimal adverse reactions. The cells and regenerative factors in BMAC can help accelerate healing, reduce pain, and improve function in areas like joints, tendons, and cartilage. For athletes or active individuals, this can mean a quicker recovery and faster return to the activities you love.

Another significant benefit is the minimally invasive nature of the procedure. Compared to traditional surgical options, BMAC is less invasive (even if it does sound like it - I know it seems a bit scary), but often is only a brief outpatient procedure and a relatively quick recovery time. This can be especially appealing for those looking to avoid more invasive treatments. However, like any medical procedure, BMAC has its limitations.

The Bad - one of the main concerns is that its effectiveness can vary from patient to patient. While many experience significant improvement, others may not see the same level of benefit. This variability can be influenced by factors such as the severity of the injury, the area being treated, and individual patient factors. Additionally, while the procedure itself is minimally invasive, it still carries some risks, including infection, bleeding, fracture, or discomfort at the site of bone marrow extraction. Although these risks are generally low, they are important to consider.

The Truth - about BMAC is that while it's a promising and exciting option, it's not a one-size-fits-all solution. Ongoing research is crucial to fully understand its potential and optimize its use. It's essential for patients to have realistic expectations and to discuss their specific condition and treatment goals with their healthcare provider. BMAC is usually reserved for more severe pathology while prolotherapy, Prolozone, or PRP can be more appropriate for lesser disease or first line treatments.  At times, we will combine these treatments. Depending on the changes in the bone of an arthritic joint, I may consider placing PRP in the bone below the cartilage defect while the BMAC goes into the joint. 

At NJRI, we’re committed to providing the best care and using the most effective treatments available. BMAC can be a powerful tool in the right circumstances, but it’s important to approach it with a clear understanding of what it can and cannot do.

In summary, BMAC offers a unique approach to enhancing the body’s natural healing processes, particularly for more severe injuries. It has its advantages, such as leveraging your own regenerative abilities and being minimally invasive. However, its effectiveness can vary, and there are risks to consider. As always, it’s important to have a detailed conversation with your healthcare provider to determine if BMAC is the right choice for you. Feel free to give our office a call. If you believe that a BMAC may be the right choice for you. My team and I would be honored to have the opportunity to evaluate you and propose a treatment plan to get you back to doing what you love.

Thanks for tuning in to this episode of "The Good, The Bad, and The Truth About Regenerative Medicine." If you found this information helpful, don’t forget to like, share, and subscribe to our channel. 

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Stay tuned for our next episode where we’ll explore another cutting-edge treatment in regenerative medicine. Until then, stay healthy and active!