Concentrated Bone Marrow Aspirate for the Treatment of Chondral Injuries and Osteoarthritis of the Knee. A Systematic Review of Outcomes.

These studies have shown bone marrow aspirate concentrate (BMAC) injections into the knee to be safe with variable benefits to cartilage defects. 11 studies were selected to meet criteria after analyzing 35 studies from 1980 onward. Some individual studies reviewed found benefits to include:
· 80% of grade 4 chondral lesions had complete recovery of cartilage confirmed by MRI and arthroscopy
· 81% of large patellofemoral lesions had complete filling of the lesions at 3 year follow up
· 96% of patients had improvement in function, symptoms, and quality of life
· Some studies also found positive results by adding BMAC to surgical procedures

The Takeaway: BMAC is made up of nucleated cells, including mesenchymal stem cells, that assist in the healing of tissues. If you have had a knee injury that resulted in a cartilage injury, consider getting an injection of BMAC instead of surgery. If you must have surgery, consider finding a surgeon who is willing to implement BMAC into your procedure for even better results. Of course, these results hinge on aspiration technique and the method of cellular processing.

Be sure your doctor is using techniques that maximize cellular counts from both the bone marrow aspiration, AND the bone marrow processing. Just like any medicine used today, proper dosing is crucial for outcomes. For example, taking 1mg of Tylenol is ineffective but taking 500mg of Tylenol will give you good pain relief. In the same respect, 4 million cells is very different from 400 million cells when treating large joints. Taking shortcuts on either the bone marrow aspiration technique or the BMAC cell processing could reduce the outcomes. If you want to learn more, schedule an appointment with Dr. Silva.

Reference:
Concentrated Bone Marrow Aspirate for the Treatment of Chondral Injuries and Osteoarthritis of the Knee. A Systematic Review of Outcomes. Orthop J Sports Med. 2016 Jan 13;4(1):2325967115625481.

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