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BMAC.
Information before decisions.
Understand what BMAC is, how it is obtained, and what to ask about its use for your condition. An individualized evaluation puts the options and expectations in context.
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Patients cared for with knee osteoarthritis, meniscus damage, and knee injuries.
Providing regenerative medicine care at NSI.
Clinical experience reported by NeuroSpinal Institute of Broward.
Less pain.
Better function.
NSI reports outcomes from more than 3,000 patients treated for knee osteoarthritis, meniscus damage, and knee injuries, with assessments at 6 and 9 months after treatment. Improvement was defined as pain reduction together with better function.
Initial treatment course: one BMAC procedure and two PRP injections.
Improved after the initial course
Experienced reduced pain and improved function following the initial BMAC and PRP treatment course.
Further improvement with a second BMAC
Had some initial benefit and received a second BMAC procedure to achieve further pain reduction and functional improvement.
Did not respond favorably
Did not experience a favorable response to treatment.
Decisions about a second treatment depend on the individual response. At NSI, we generally do not repeat BMAC when there has been no improvement after the initial course.
Source: internal patient follow-up reported by NSI. These percentages summarize NSI’s clinical experience with the combined BMAC and PRP protocol. Individual results vary, and a specific outcome is not guaranteed.
What is BMAC?
BMAC is a concentrated preparation obtained from a patient’s own bone marrow aspirate. It contains a mixture of cells and other components; it is not a pure or standardized dose of stem cells. Its composition can vary.
What the procedure
may involve.
Evaluate and consent
Review the diagnosis, alternatives, risks, costs and goals before deciding. Ask who will perform each part of the procedure.
Collect and prepare
Bone marrow is drawn through a needle, usually from the pelvis with local anesthetic. The sample is processed to obtain the concentrate.
Apply and follow up
The team explains the application site, technique, whether imaging guidance is appropriate, and plans for aftercare and reassessment.
Research that informs
personalized care.
A conversation about BMAC starts with your diagnosis, your goals, and research relevant to your situation. At your evaluation, we will discuss the proposed procedure, expected benefits, risks, alternatives, and follow-up.
Explore the studies below and bring your questions to your consultation.
Encouraging findings
in cartilage repair.
The selected studies below describe encouraging imaging and repair-tissue findings following surgical procedures that combined BMAC with other techniques to treat focal cartilage defects. These findings relate to those combined procedures, and individual results vary.
37 patients · prospective nonrandomized study
In the BMAC group (18 patients), MRI showed complete defect filling in 81%; biopsies from a small subset showed hyaline-like features. Both treatment groups improved clinically.
Context: Surgical repair of focal patellofemoral lesions, compared with chondrocyte implantation.
40 patients · BMAC with a hyaluronan scaffold
MRI showed complete filling in 80% of the over-45 group and 71% of the younger group. Five biopsies showed repair with varying amounts of hyaline-like tissue.
Context: All participants received combined surgery; the study compared outcomes between age groups.
165 patients · BMAC, hyaluronic acid scaffold and PRP
At one year, all KOOS subscales improved. Mean MRI cartilage-repair MOCART-2.0 score was 71; 36% scored above 80, the authors’ excellent-repair category.
Context: Combined surgery for full-thickness defects in patients averaging 26.4 years old.
A documented finding
on MRI.
In this knee MRI report, the radiologist describes cartilage regeneration in a previously documented full-thickness trochlear defect.
“regeneration of cartilage in the previously demonstrated full-thickness defect.”
Excerpt from the radiologist’s report.
The clinical history mentions prior stem cell therapy, but the document does not identify the preparation as BMAC. This is an individual imaging observation: it does not establish what caused the change or predict other patients’ results.
Patient identifiers removed.
Your assessment
guides the decision.
Discuss infections, blood or bleeding disorders, cancer, allergies, pregnancy and all medications and supplements. Both aspiration and injection require review of your individual risks. Do not stop medicines on your own.
Prepare for recovery.
Agree on follow-up.
Request written instructions on wound care, medication, activity, work, driving and rehabilitation. Ask whether you need someone to accompany you and when progress will be reviewed. There is no single timeline for every patient.
Contact the team for fever, drainage, increasing redness or severe worsening pain. Seek urgent assessment for serious symptoms or significant new weakness.
Frequently asked questions
Is this the same as a stem-cell injection?
BMAC contains a mixture of marrow cells and other components. Simply calling it a stem-cell injection can create a misleading impression of its composition and benefits.
Is BMAC better than PRP?
There is no universal answer. The comparison depends on the diagnosis, preparations and available evidence. A more complex or expensive technique does not guarantee better results.
Can it cure a bone-on-bone knee?
A cure or cartilage regeneration should not be promised. Advanced arthritis requires discussion of realistic goals and all appropriate alternatives.
How many procedures will I need?
This should be decided after evaluation. Ask for the reasoning behind any repeat procedure, total costs and reassessment timing.
Will insurance cover it?
Do not assume coverage. Confirm with your insurer and request written costs for aspiration, processing, application and follow-up.
What should I bring to a consultation?
Bring available images and reports, a medication list and previous treatment details. Prepare questions about risks, evidence and goals.
Further reading: HSS: biologic therapies ↗ · AAOS OrthoInfo ↗
Related patient information
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