Bone Marrow Aspirate (BMA): Patient Information Sheet

BONE MARROW ASPIRATE (BMA): PATIENT INFORMATION SHEET

ph: (07) 5597 5711

email: receptionostpath@gmail.com

Dr Frances Hill M.B.B.S – Medical Practitioner

David Krizanic B.Clin.Sc. / B.O.Sc – Osteopath

BMA Explained

Bone marrow aspirate (BMA) is used in musculoskeletal medicine to focus your own body’s ability to heal. It has many well-done published randomized control trials (RCT) and studies which demonstrate both its effectiveness and safety in many musculoskeletal conditions, including osteoarthritis, tendinopathies, and damaged vertebral discs. BMA has been in clinical use since the 1990’s and has the most potential for musculoskeletal repair. The bone marrow is a rich source of mesenchymal stem cells (MSCs), which are a potent cell for focusing the body’s own repair process. MSCs bind to an injury site and initiate and organize repair to the damaged tissue. Precisely placing BMA into the site of injury will initiate the healing process by activating on the damaged cartilage or tendon. This is an inflammatory process, and inflammation is the vital first phase of healing.

What to expect and how to prepare for BMA Procedure

  • Depending on the procedure, you may need to arrange for a driver to bring you home. We can provide crutches as needed.
  • 5 days prior to the procedure: Stop taking anti-inflammatory drugs like ibuprofen, Naprosyn, Celebrex. Please let us know if you have been taking prednisone or other corticosteroids in the last month.
  • The day of the procedure: thoroughly shower and clean your skin (We advocate the use of Sapoderm antibacterial soap). We prefer you not shower for 24 hours post procedure.
  • The day of the procedure: Wear loose-fitting clothing. BMA will initiate healing and a productive inflammation, and BMAC therapy will make the body part treated sore for 5-7 days to up to 2-3 weeks. Anti-inflammatory drugs (i.e. ibuprofen, Naprosyn, Celebrex) and corticosteroids such as prednisone can blunt or stop this process, so it is important to not take any anti-inflammatory drugs for 5 days before getting BMA procedure, or for at least three weeks after the procedure. Corticosteroid injections can blunt inflammation for 30 days, so let us know if you have had one recently. Depending on the body part being treated, you may be in a sling or on crutches for several days. If you load or tense a tendon or ligament that has just been injected with BMA, some of the BMA injected will perfuse out. So, by keeping the body part treated relaxed by using a sling (for the shoulder or arm) or crutches (for hips and legs) for a few days, the BMA can bind in place and do its job.

  • What happens during the BMAC procedure?

    First, your bone marrow is aspirated or drawn out from the region as discussed during your consultation. (Pelvis or proximal region to the tibia or shin bone) This is really not as bad as it might sound. The area is then thoroughly cleaned with a surgical skin preparation called Chloroprep and draped. Using ultrasound guidance and sterile ultrasound gel, we will use a skin marking pen to map the procedure. We then numb the skin and the surface of the bone at the aspiration site. After the skin is numb, we use a special needle designed to go through bone to enter the bone marrow cavity. Then we aspirate the bone marrow into a syringe with a small amount of anti-coagulant (heparin) in it to keep the bone marrow from clotting during this process. A sterile dressing is placed over the aspiration site. The bone marrow aspirate may be directly injected into the regions of interest or it may be filtered to remove very tiny bone fragments and is transferred in sterile fashion into a special centrifuge tube. It is then centrifuged for two cycles to isolate the MSCs to make the final Bone Marrow Aspirate Concentrate (BMAC).

    What to do after your procedure

    You will be given specific medicine to control any discomfort you may have after the procedure. Avoid NSAIDs like ibuprofen. Paracetamol can be used for mild pain. Avoid showering for 1 day and avoid immersion in water for 5 days. Depending on the part of the body treated, usually you will be placed in a sling or on crutches for 1 to 3 days. Do your best not to tense or load the treated area during this time. After 3 days, unless otherwise instructed, the treated body part should be used and slowly moved through its full range of motion. It will be sore, but you will not be doing damage by moving it, in fact it needs to move to heal. If you were on crutches for a period of time, walking is good once you are off the crutches. Exercise is vital to good health and finding a way to cross train around your injury is important. Usually, depending on the initial injury, physical therapy is started from 2-3 weeks following the procedure. Improvements in pain and function can be expected from 2-3 months following the procedure.