A Comprehensive Guide to Concentrated Bone Marrow Aspirate

What is Concentrated Bone Marrow Aspirate?

Concentrated Bone Marrow Aspirate (cBMA) is a regenerative medicine therapy that is derived from a patient's own bone marrow. It is used to promote healing and tissue regeneration by utilizing the body's natural healing capabilities. cBMA is rich in a variety of  cells, including mesenchymal stem cells (MSCs), hematopoietic stem cells (HSCs), and various growth factors, making it a considerable treatment option for a range of conditions.

How is Concentrated Bone Marrow Aspirate Made?

The process of creating cBMA involves several steps:  

1. Bone Marrow Harvesting: A sample of bone marrow is collected from the patient's pelvis or tibia using a specialized aspiration needle. This procedure is usually performed under local anesthesia and takes about 20-30 minutes.  
2. Centrifugation: The collected bone marrow is then placed in a centrifuge, a device that spins the sample at high speeds. This process separates the bone marrow into its various components based on their density.
3. Concentration: The centrifugation process concentrates the cells and growth factors within the bone marrow and isolates the most beneficial components. The final product, concentrated bone marrow aspirate, is ultimately used for therapeutic purposes.

What Does Concentrated Bone Marrow Aspirate Do?

cBMA is utilized in various medical applications, primarily due to its high content of regenerative cells and growth factors. Some of its key functions include:

1. Promoting Tissue Repair: The cells and growth factors in cBMA can be used to aid in the repair and regeneration of damaged tissues. These properties make cBMA a potential treatment option for musculoskeletal injuries and degenerative conditions⁶.
2. Enhancing Bone Healing: cBMA is often used in orthopedic procedures, such as spinal fusions and fracture repairs to contribute to bone healing and aid in the reduction of recovery times.
3. Reducing Inflammation: The anti-inflammatory properties of the cells and growth factors in cBMA can be used to help reduce inflammation, which can be beneficial in treating conditions like osteoarthritis.
   
   

Comparing Platelet Rich Plasma to Concentrated Bone Marrow Aspirate – What’s the Difference?

Platelet-Rich Plasma (PRP)

Source: Derived from the patient's own blood.

Components: Contains a high concentration of platelets and growth factors.

Function: Primarily used to enhance healing in soft tissues, such as tendons and ligaments. It may be used to promote tissue regeneration and reduce inflammation.

Applications: Commonly used in orthopedics, sports medicine, and aesthetic treatments.

• Joint injuries¹
• Tendonitis²
• Muscle Strains²
• Osteoarthritis³
• Hair growth⁴
• Wrinkle reduction⁵

Concentrated Bone Marrow Aspirate

Source: Derived from the patient's bone marrow.

Components: Contains mesenchymal stem cells, hematopoietic stem cells, and various growth factors.

Function: Can be used to aid in the repair and regeneration of both bone and soft tissues.

Applications: May be used in orthopedic procedures, treatment of musculoskeletal injuries, and managing degenerative conditions.

• Cartilage repair⁶
• Fractures⁷
• Discogenic pain⁸
• Spinal fusions ^9,10

Key Differences:

Cell Content: cBMA contains a broader range of regenerative cells compared to PRP, which is mainly comprised of platelets.

Applications: While PRP can be an excellent option for soft tissue repair and aesthetic treatments, cBMA is more versatile, and is known to have a larger impact on bone and soft tissue regeneration¹¹.

Harvesting Process: PRP is easier to prepare as it involves drawing blood, whereas BMA requires a bone marrow aspiration procedure.

Both PRP and Concentrated Bone Marrow Aspirate have the potential to offer significant benefits for patients. The choice between the two depends on the specific medical condition and the desired outcome. While PRP may be ideal for enhancing healing in soft tissues, BMA provides a comprehensive solution for both bone and soft tissue regeneration.

1.  Kon et al, Platelet-rich plasma: intra-articular knee injections produced favorable results on degenerative cartilage lesions; Knee Surg Sports Traumatol Arthrosc DOI10.1007/s00167-009-0940-8, April 2009

2.  Mishra, Treatment of Tendon and Muscle using Platelet-Rich Plasma; 2009

3.  Filardo/Kon et al: Platelet-rich plasma intra-articular knee injections for the treatment of degenerative cartilage lesions and osteoarthritis, Feb. 2010

4.  Li et al. Autologous Platelet-Rich Plasma: A Potential Therapeautic Tool for Promoting Hair Growth; American Society for Dermatologic Surgery, Inc. 2012;1040-1046.

5.  Cho et al. Effect of Platelet-Rich Plasma on Ultraviolet b-Induced Skin Wrinkles in Nude Mice. Journal of Plastic, Reconstructive & Aesthetic Surgery 2011; 64: e31-e39.

6.  Hannon CP, et al.Arthroscopic Bone Marrow Stimulation and Concentrated Bone Marrow Aspirate for Osteochondral Lesions of the Talus: A Case-Control Study of Functional and Magnetic Resonance Observation of Cartilage Repair Tissue Outcomes.Arthroscopy2016;32:339-347

7.  Rodriguez-Collazo ER, Urso ML.Combined Use of the Ilizarov Method,Concentrated Bone Marrow Aspirate (cBMA), and Platelet-Rich Plasma (PRP) to Expedite Healing of Bimalleolar Fractures.Strategies Trauma Limb Reconstr2015;10:161-166

8.  Pettine KA, Murphy MB, Suzuki RK, Sand TT. Percutaneous Injection of Autologous Bone Marrow Concentrate Cells Significantly Reduces Lumbar Discogenic Pain Through 12 Months.Stem Cells. 2014;33(1):146-156. doi:10.1002/stem.1845.

9.  Ajiboye RM, Hamamoto JT, Eckardt MA, Wang JC.Clinical and radiographic outcomes of concentrated bone marrow aspirate with allograft and demineralized bone matrix for posterolateral and interbody lumbar fusion in elderly patients. European Spine Journal. 2015;24(11):2567-2572.doi:10.1007/s00586-015-4117

10.  Hart R, Komzák M, Okál F, Náhlík D, Jajtner P, Puskeiler M.Allograft alone versus allograft with bone marrow concentrate for the healing of the instrumented posterolateral lumbar fusion. The Spine Journal. 2014;14(7):1318-1324. doi:10.1016/j.spinee.2013.12.014.

11.  Danilkowicz R, et al. Nonoperative and Operative Soft-Tissue and Cartilage Regeneration and Orthopaedic Biologics of the Foot and Ankle: An Orthoregeneration Network Foundation Review. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2022;38(7):2350-2358. doi:10.1016/j.arthro.2022.03.042.