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Bone Marrow Concentrate

Stem cells are immature cells that have the ability to develop into bone, cartilage, muscle, tendon, or ligament. In orthopedics, the most common form of cell based treatment, or "stem cell" injection, uses concentrated mixture of mesenchymal stem cells (MSC's), platelets, interleukins and other from the patients own body. The objective of these cellular-base therapies is to harness the natural regenerative ability of these tissues, and to create a healing environment.

These mesenchymal stem cells (MSCs) can be taken from either bone marrow or fat (adipose) tissue, and either of these techniques can be performed in the office. After the cells are collected, the components that are not beneficial to healing are filtered out, and the beneficial cells are then injected into an injured area with the goal of reducing pain and improving function.

All autologous cellular based procedures using the patient’s own cells, and are done with minimal manipulation of the cells, with protocol that are compliant with published FDA guidelines. The procedures are performed as a same-day procedure, with cells being harvested, isolated and injected within a period of a few hours.

WHAT TYPE OF CONDITIONS ARE TREATED?

At Boston Sports & Biologics, we manage minor orthopedic conditions we orthobiologic injections. Many of these injuries can be treated with platelet rich plasma injections. More severe muscle, ligament and tendon tears, moderate to severe joint arthritis, and degenerative joint conditions are treated with bone marrow concentrate injections. Patient with mild arthritis tend to show greater improvements than do patients with higher-grade or more severe arthritis. Recent studies have also shown benefit with bone marrow aspirate derived stem cells in treated partial meniscus tears.

HOW DO CELLULAR BASED TREATMENTS WORK?

Mesenchymal Stem Cells (MSCs) are a special type of cell that can differentiate and develop into different types of cells depending on the signals they receive from surrounding tissues. MSCs can become bone cells (osteoblasts), cartilage cells (chondrocytes), fat cells (adipocytes) or muscle cells (myocytes).

MSCs have been used in orthopedics for more than two decades, and the injection of autologous stem cells to treat arthritis has shown improvement in pain and function. Stem cells injection for knee osteoarthritis is still a relatively new treatment, but based on current evidence, MSCs therapy is effective in relieving pain and improving function in patients with knee OA (Song et al 2020). The cells do no regenerative cartilage in any significant way.

HOW DO YOU KNOW WHERE TO PLACE THE CELLS?

We use ultrasound to identify the injured tendon, ligament or joint, and to guide the needle for the injection.

HOW OFTEN WILL I NEED TO REPEAT THE PROCEDURE?

Most patients will need only one procedure, but sometimes more than one injection is needed.

ARE STEM CELL PROCEDURES COVERED BY INSURANCE?

Cellular based procedures are too new to be covered by insurance. Insurance plans typically cover the initial consultation, follow-up appointments and therapy. Our billing department can answer questions regarding cost.

ARE STEM CELL TREATMENTS FDA APPROVED?

Stem cell treatments are NOT FDA cleared in the United States, and patients are often lured by unverified claims. The FDA has issued compliance guidelines regarding the use of human cells, tissues, and cellular or tissue-based products, and the FDA has recently issued Patient and Consumer Information about regenerative medicine therapies. We recognize the FDA’s role in assuring patient safety, and all of our treatment protocols are compliant with the published FDA guidelines.

At Boston Sports & Biologics, we use the peer-reviewed published medical literature when available and offer patients a spectrum of treatment of treatment options. Our goal is to offer a comprehensive multi-disciplinary approach that is right for you, and based on strong scientific and clinical evidence. All of the commercial systems we use to process autologous cellular products for our bone marrow concentrate and Lipogems procedures have received FDA-clearance to assure purity and potency. We do not culture cells.

Don't be lured by unverified claims

More and more ads online, in newspapers, magazines, and billboards for unproven “stem cell therapies”. Unproven treatments may present serious health, personal and financial considerations. Ensure you go to a physician that practices in compliance with FDA guidelines and is guided by peer-reviewed published medical literature when available.

BONE MARROW DERIVED STEM CELL RESEARCH ARTICLES


OSTEOARTHRITIS


Knee

  • A dose response analysis of a specific bone marrow concentrate treatment protocol for knee osteoarthritis. BMC Musculoskelet Disord. 2015. Link to article
  • Bone Marrow Cellular Therapies: Novel Therapy for Knee Osteoarthritis. J Knee Surg. 2018. Link to article
  • A Prospective, Single-Blind, Placebo-Controlled Trial of Bone Marrow Aspirate Concentrate for Knee Osteoarthritis. Am J Sports Med. 2017. Link to article
  • Intra-articular injection of two different doses of autologous bone marrow mesenchymal stem cells versus hyaluronic acid in the treatment of knee osteoarthritis: multicenter randomized controlled clinical trial (phase I/II). J Transl Med. 2016. Link to article
  • Efficacy of mesenchymal stem cells injection for the management of knee osteoarthritis: a systematic review and meta-analysis. Int Orthop. 2015. Link to article
  • Long-Term Follow-up of Intra-articular Injection of Autologous Mesenchymal Stem Cells in Patients with Knee, Ankle or Hip Osteoarthritis. Arch Iran Med. 2015. Link to article
  • Autologous bone marrow concentrate: review and application of a novel
    intra-articular orthobiologic for cartilage disease.
    Phys Sportsmed. 2013. Link to article
  • Regenerative injection therapy with whole bone marrow aspirate for degenerative joint disease: a case series. Clin Med Insights Arthritis Musculoskelet Disord. 2013. Link to article
  • Clinical outcome of autologous bone marrow aspirates concentrate (BMAC) injection in degenerative arthritis of the knee. Eur J Orthop Surg Traumatol. 2014. Link to article
  • Mesenchymal stem cells for the treatment of cartilage lesions: from preclinical findings to clinical application in orthopaedics. Knee Surg Sports Traumatol Arthrosc. 2013. Link to article
  • Mesenchymal stem cell injections improve symptoms of knee osteoarthritis. Arthroscopy. 2013. Link to article
  • Intra-articular injection of mesenchymal stem cells for the treatment of osteoarthritis of the knee: a proof-of-concept clinical trial. Stem Cells. 2014. Link to article
  • Repair of articular cartilage defects in the patello-femoral joint with autologous bone marrow mesenchymal cell transplantation: three case reports involving nine defects in five knees. J Tissue Eng Regen Med. 2007. Link to article
  • Increased knee cartilage volume in degenerative joint disease using percutaneously implanted, autologous mesenchymal stem cells. Pain Physician. 2008. Link to article

Hip

  • Mesenchymal stem cell therapy in the treatment of hip osteoarthritis. J Hip Preserv Surg. 2017. Link to article
  • Long-Term Follow-up of Intra-articular Injection of Autologous Mesenchymal Stem Cells in Patients with Knee, Ankle or Hip Osteoarthritis. Arch Iran Med. 2015. Link to article

Ankle

  • Long-Term Follow-up of Intra-articular Injection of Autologous Mesenchymal Stem Cells in Patients with Knee, Ankle or Hip Osteoarthritis. Arch Iran Med. 2015. Link to article

MENISCUS TEAR

  • Treatment of Knee Meniscus Pathology: Rehabilitation, Surgery, and Orthobiologics. PM&R. 2018. Link to article
  • Potential use of mesenchymal stem cells in human meniscal repair: current insights. Open Access J Sports Med. 2017. Link to article
  • Adult human mesenchymal stem cells delivered via intra-articular injection to the knee following partial medial meniscectomy: a randomized, double-blind, controlled study.J Bone Joint Surg Am. 2014. Link to article
  • Effects of intra-articular administration of autologous bone marrow aspirate on healing of full-thickness meniscal tear: an experimental study on sheep. Acta Orthop Traumatol Turc. 2012. Link to article

TENDON TEARS

Patella Tendon Tear

  • Treatment of chronic patellar tendinopathy with autologous bone marrow stem cells: a 5-year-followup. Stem Cells Int. 2012. Link to article

Rotator Cuff Tendon

  • Effect of Bone Marrow Aspirate Concentrate-Platelet-Rich Plasma on Tendon-Derived Stem Cells and Rotator Cuff Tendon Tear. Cell Transplant. 2017. Link to article
  • A prospective multi-site registry study of a specific protocol of autologous bone marrow concentrate for the treatment of shoulder rotator cuff tears and osteoarthritis. J Pain Res. 2015. Link to article


Safety Studies in Orthopedics

  • Efficacy and safety of mesenchymal stem cell injections for patients
    with osteoarthritis: a meta-analysis and review of RCTs.
    Arch Orthop
    Trauma Surg.
    2021. Link to article
  • A multi-center analysis of adverse events among two thousand, three
    hundred and seventy two adult patients undergoing adult autologous stem
    cell therapy for orthopaedic conditions.
    Int Orthop. 2016. Link to article
  • Safety of autologous bone marrow aspiration concentrate transplantation: initial experiences in 101 patients. Orthop Rev (Pavia). 2009. Link to article


Like all medical procedures, regenerative procedures have a success and failure rate. Not all patients will experience the same results, and results may vary based on an individual’s overall condition, severity of the pathology and recovery time.