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Bone Marrow Aspiration in Orthopedics

What is human bone marrow?

Human bone marrow is a rich source of mesenchymal stem cells or MSCs, as well as growth factors and cytokines natural occurring in the human body. The most important source of stem cells is bone marrow from the iliac crest at the top of the pelvis. This is the ideal location because the iliac crest contains the highest concentration of stem cells and it is just under the skin, so bone marrow is easily harvested.

Mesenchymal stem cells are immature cells that are influenced by their surroundings and have the capacity to differentiate into multiple types of cells. When injected into an injury site, a stem cell can develop into the kind of cell needed to help in healing.

MSCs extracted from bone marrow aspirate can reduce inflammation and repair and regenerate damaged tissues to decrease pain, reduce the need for medication, and restore function lost due to aging, disease, trauma, and damage of bone, cartilage and other connective tissues making them valuable to promote healing and regeneration.

Bone marrow aspiration is a medical procedure that involves the extraction of bone marrow from the pelvic bone. The procedure is performed under local anesthesia to numb the area where the aspiration will occur. Using a special needle, Dr. Reynolds will access the bone marrow cavity at the iliac crest (hip bone). A syringe is attached to the needle to aspirate a sample of bone marrow. After the aspiration, pressure is applied to the site to control any bleeding. The sample is then processed to concentrate the stem cells. Concentrated bone marrow aspirate can be used during surgery and/or as a separate treatment for joint pain and dysfunction. It can enhance tissue repair by treating inflammation and support cell growth.

  • Bone fractures and non-unions: Bone marrow aspirate contains MSCs that can be used to accelerate bone healing and improve the union of fractures that are slow to heal or have failed to heal (non-unions).
  • Avascular necrosis: Avascular necrosis is the death of bone tissue due to a lack of blood supply. Bone marrow aspirate can be utilized to introduce MSCs into the affected area, promoting new bone formation and potentially delaying or preventing joint collapse.
  • Spinal disc degeneration: In certain cases of degenerative disc disease, bone marrow aspirate may be used as part of a procedure to inject MSCs into damaged spinal discs, with the goal of promoting disc repair and reducing pain.
  • Ligament and tendon injuries: Bone marrow aspirate can be employed in procedures to augment the healing of torn ligaments or tendons, such as the anterior cruciate ligament (ACL) in the knee, Achilles tendinopathy, tennis elbow, and rotator cuff tears.
  • Osteoarthritis: Osteoarthritis is a degenerative joint disease characterized by the breakdown of joint cartilage and underlying bone changes. Bone marrow aspirate concentrate (BMAC) or MSCs are a safe therapeutic option to treat osteoarthritis. BMAC can be used to stimulate cartilage repair and reduce pain and inflammation in affected joints, such as the knee, hip, or shoulder.
  • Osteochondral defects: These are localized areas of cartilage and underlying bone damage in joints, often caused by trauma or repetitive stress. Bone marrow aspirate can be used in surgical procedures to promote the regeneration of both cartilage and bone at the defect site.

Bone marrow aspiration can be performed as both an office-based procedure and as an inpatient or outpatient procedure in a hospital or medical center, depending on the specific purpose, the circumstances and the resources available.

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