Bone Marrow Aspirate Concentrate for Knee Osteoarthritis

Bone Marrow is the liquid spongy-type tissue found in the hallow (interior) of bones. It is primarily a fatty tissue that houses stem cells which are responsible for the formation of other cells. These mesenchymal stem cells (MSC), also called marrow stromal cells, can differentiate (change) into a variety of cell types including osteoblasts (bone cells), chondrocytes (cartilage cells), myocytes (muscle cells), adipocytes (fat), fibroblasts (ligament and tendon) and others when reintroduced into the body by injection. Bone marrow also contains hematopoietic stem cells that give rise to the white and red blood cells and platelets.

Doctors at the Mayo Clinic and Yale University are among the first to get 2017 research out on the benefits of Bone Marrow Aspirate Concentrate for Knee Osteoarthritis. Here is the summary of that research:

  • Bone marrow aspirate concentrate (BMAC) is increasingly used as a regenerative therapy for musculoskeletal pathological conditions despite limited evidence-based support.
  • HYPOTHESIS: BMAC will prove feasible, safe, and efficacious for the treatment of pain due to mild to moderate degenerative joint disease of the knee.

In their single-blind, placebo-controlled trial, 25 patients with bilateral knee pain from bilateral knee osteoarthritis were randomized to receive BMAC into one knee and saline placebo into the other.

Early results show that BMAC is safe to use and is a reliable and viable (stem cell) cellular product. Study patients experienced a similar relief of pain in both BMAC- and saline-treated arthritic knees.1


Bone is a rich source of mesenchymal stem cells and has the potential to repair cartilage damage in osteoarthritis, and potentially slow down or improve the disease process.

Bone marrow is easily harvested from the posterior iliac crest (pelvic bone)  and concentrated in an FDA compliant device.

The resultant Bone marrow concentrate has been shown to provide elevated levels of the healing factors listed above” hematopoietic stem cells, mesenchymal stem cells, blood platelets, chemokines (attracts white blood cells to areas of injury or infection) and cytokines (growth factor for healing).

Bone marrow concentrate also has anti-inflammatory, angiogenic (forms new blood vessels for improving circulation to injured area) and immunomodulatory properties (stimulates immune response) that can potentially enhance cartilage repair.2

Prolotherapy injections to enhance treatment

Additional injections are typically performed at the injury sites into and around the areas to enhance the healing effect. Most patients also receive Hackett-Hemwall Prolotherapy to help stabilize the joint and stimulate the repair of other structures that are contributing to the joint instability and/or pain for the patient.


1 Shapiro SA, Kazmerchak SE, Heckman MG, Zubair AC, O’Connor MI. A Prospective, Single-Blind, Placebo-Controlled Trial of Bone Marrow Aspirate Concentrate for Knee Osteoarthritis. Am J Sports Med. 2017 Jan;45(1):82-90. doi: 10.1177/0363546516662455. Epub 2016 Sep 30. [Pubmed]

2 Oliver KS, Bayes MD Crane D, Pathikonda C. Clinical Outcome of Bone Marrow Concentrate in Knee Osteoarthritis. Journal of Prolotherapy. 2015;7:e937-e946.

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