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Biologic Modality

Bone Marrow
Aspirate Concentrate

An autologous biologic harvested from the iliac crest, concentrated to deliver mesenchymal stem cells, hematopoietic progenitors, and a full spectrum of growth factors directly to the treatment site. Same-day processing. No donor tissue. Established in orthopedic surgery, spine, and cartilage repair.

Autologous ACL repair Cartilage Spine Knee OA Same-day Orthopedics
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MSCs
Stem cells present
Same
Day processing
Iliac
Crest harvest site
IRB
Largest in biologics

How it works

Mechanism of action

BMAC concentrates the body’s own regenerative cells from bone marrow and delivers them directly to the site of injury. Unlike exosomes or WJ-MSCs, BMAC brings live stem cells, progenitor cells, and growth factors all in one autologous preparation.

01
Iliac Crest Aspiration
Bone marrow is aspirated from the posterior iliac crest under local anesthesia. The procedure takes 20-30 minutes. Aspiration volumes of 30-60mL are typical. The iliac crest is the preferred site for its high MSC concentration and accessibility.
02
Centrifugation & Concentration
The aspirate is spun in a centrifuge to separate and concentrate the mononuclear cell layer containing MSCs, hematopoietic stem cells, endothelial progenitors, and platelets. The resulting BMAC is a potent autologous preparation ready for same-day injection.
03
MSC & Progenitor Cell Delivery
BMAC delivers MSCs capable of differentiating into cartilage, bone, and connective tissue. Hematopoietic progenitors support vascular repair. The combination of live cells and growth factors creates both immediate signaling effects and longer-term regenerative potential.
04
Cartilage Regeneration
BMAC-derived MSCs can differentiate into chondrocytes under the right conditions. Combined with growth factors (TGF-β, BMP-2, IGF-1), BMAC stimulates new cartilage matrix formation — making it particularly valuable in osteoarthritis and cartilage defect applications.
05
Subchondral Bone Remodeling
In knee OA, subchondral bone degeneration plays a critical role in disease progression. BMAC promotes subchondral bone remodeling through osteogenic progenitor cells and growth factors — addressing the underlying bone pathology, not just symptoms.
06
Graft Integration Support
In ACL reconstruction, BMAC applied to the graft and tunnel enhances biological integration. Growth factors (VEGF, PDGF, TGF-β) promote angiogenesis and collagen remodeling at the graft-bone interface — accelerating tunnel healing and potentially improving long-term graft stability.

Where it works

Clinical Applications

BMAC is most established in orthopedic and spine applications. Its combination of MSCs, hematopoietic progenitors, and growth factors makes it particularly suited for structural repair where cartilage, bone, and ligament healing are the primary goals.

🧎
Knee Osteoarthritis
Cartilage repair · Subchondral bone · OA delay
 💪
ACL Reconstruction
Graft augmentation · Tunnel healing · Integration
 🦴
Spine & Disc
Discogenic pain · Intradiscal injection · Degeneration
 🔥
Cartilage Defects
Chondral lesions · High tibial osteotomy · Repair
 🩹
Critical Limb Ischemia
Diabetic limb · Vascular repair · Angiogenesis
 ⚽
Sports Medicine
Rotator cuff · Meniscus · Bone healing
 🏃
Tendon Repair
Achilles · Patellar · Rotator cuff augmentation
 🦷
Oral & Maxillofacial
Bone grafting · Implant support · Jaw reconstruction

Evidence base

Peer-reviewed research on
Bone Marrow Aspirate Concentrate

Selected from PubMed, PMC, and ClinicalTrials.gov. BMAC has one of the strongest clinical evidence bases of any orthopedic biologic.

Review
Bone marrow aspirate concentrate for knee osteoarthritis: clinical efficacy, cartilage regeneration, and future directions
Medicina (MDPI) · May 2025 · Park et al. · Narrative review comparing BMAC to HA, PRP, and corticosteroids — cartilage regeneration, inflammation modulation, and TKA delay potential
 Meta-analysis
Biological augmentation of ACL reconstruction with BMAC: systematic review and meta-analysis of randomized controlled trials
International Orthopaedics · Jan 2025 · Park et al. · BMAC augmentation shows potential graft recovery benefits without increasing complication rates in ACL reconstruction
 Review
Management of knee osteoarthritis using bone marrow aspirate concentrate: a systematic review
PubMed · 2025 · Intra-articular BMAC injection showing effectiveness in improving functional outcomes in knee OA clinical trials
 Clinical trial
Clinical outcomes following single intradiscal injection of BMAC for single-level discogenic low back pain
ClinicalTrials.gov · NCT03912454 · Prospective study of BMAC injected into the symptomatic lumbar disc for discogenic pain
 Clinical trial
Safety and efficacy of autologous BMAC for no-option critical limb ischemia in Type-II diabetes (DIALEG)
ClinicalTrials.gov · NCT01818310 · Completed Phase II/III RCT · Intramuscular BMAC for diabetic critical limb ischemia

Common questions

Questions about
Bone Marrow Aspirate

The iliac crest aspiration is performed under local anesthesia and takes approximately 20-30 minutes. Patients typically experience pressure rather than pain during the procedure. Post-procedure soreness at the harvest site is common and usually resolves within a few days. The same-day nature of BMAC processing means the injection can follow immediately after harvest in the same appointment.
BMAC contains live MSCs capable of differentiating into cartilage — something PRP cannot provide. BMAC also promotes subchondral bone remodeling, which is a key component of OA progression that PRP does not address. The 2025 narrative review found BMAC provides short-to-mid-term symptomatic relief and functional improvement, with some studies suggesting potential to delay total knee arthroplasty. However, BMAC requires a more invasive harvest procedure than PRP and is typically more expensive.
Yes. BMAC + PRP combinations are used in orthopedic applications to combine the structural repair potential of BMAC’s MSCs with PRP’s concentrated growth factor burst. BMAC is also used alongside scaffolds (collagen, fibrin) in cartilage repair procedures. In ACL reconstruction, BMAC is applied to the graft and bone tunnel at the time of surgery as biological augmentation.
Recovery depends on the indication and injection site. For intra-articular knee injections, patients typically avoid strenuous activity for 1-2 weeks. For ACL reconstruction augmentation, recovery follows the surgical protocol. Harvest site soreness from the iliac crest typically resolves in 2-5 days. Most patients can return to light activities within a few days of a standalone BMAC injection procedure.

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Autologous · Same-Day Processing · IRB Protected
Important Regulatory Notice

Bone Marrow Aspirate Concentrate (BMAC) is an autologous biologic — derived from the patient’s own bone marrow. It is processed and used same-day under applicable FDA guidelines. BMAC is not FDA approved as a drug for specific disease indications. Clinical applications vary by indication and practitioner protocol.

These therapies have not been evaluated by the FDA for safety or efficacy for every specific indication described. They are not intended to diagnose, treat, cure, or prevent any disease. Results may vary. Clinicians are responsible for independent evaluation of suitability for each patient. This material is intended for licensed healthcare professionals only.

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Products are not FDA approved or licensed to treat, cure, or prevent any disease.