A concentrated regenerative injection drawn from your own bone marrow — considered in selected cases based on the diagnosis, the available evidence, cost, and your goals.
Bone Marrow Aspirate Concentrate — BMAC for short — is a treatment made from a small sample of your own bone marrow. The marrow is drawn from the back of the pelvis (the posterior iliac crest) using a specialized needle, then spun in a centrifuge to concentrate the cells and growth factors it contains. That concentrate is then injected, under ultrasound or fluoroscopic guidance, directly into the area we are trying to help.
You'll sometimes hear BMAC described as a "stem cell injection." That's partly true and worth being honest about. BMAC does contain mesenchymal stromal cells (often called stem cells), along with platelets, white blood cells, and a rich mix of growth factors and signaling proteins. What it is not is an "expanded stem cell" product. BMAC is an autologous, same-day procedure that remains investigational for many orthopedic applications. It has not been FDA-approved as a treatment for osteoarthritis, tendon injury, or discogenic pain. Available evidence, uncertainties, alternatives, and expected costs are reviewed during consultation.
BMAC may be considered in selected cases based on the diagnosis, prior treatment response, the available evidence, cost, and your goals. It should not be understood simply as a stronger version of PRP — it is a more involved procedure, and whether it is the right choice is decided case by case.
BMAC is generally not appropriate for end-stage "bone-on-bone" arthritis where joint replacement is the right answer, complete tendon ruptures, active infection, active cancer, or certain bleeding and bone-marrow disorders. Patients on chronic anticoagulation need careful planning in advance. As with any regenerative procedure, we'll be honest about whether you're likely to benefit before recommending it.
You'll lie face-down. The skin over the back of your pelvis is cleaned and numbed thoroughly with local anesthetic. Mild sedation is available if you'd prefer it.
Under fluoroscopic or ultrasound guidance, a specialized needle is passed through the numbed area into the iliac crest and a small volume of marrow is drawn — usually over a few minutes.
The marrow is processed in a centrifuge to concentrate the cells, platelets, and growth factors into a small final volume.
The concentrate is then injected precisely into the target joint or tendon under ultrasound or fluoroscopy. You'll rest briefly afterward. Total visit time is typically about 90 minutes.
Expect two kinds of soreness for the first few days. The harvest site — the back of your hip — is often the more noticeable of the two and can ache for up to a week, similar to a deep bruise. The injection site itself usually follows the same trajectory as PRP: increased soreness for 2 to 5 days as the healing response gets started. Ice and acetaminophen (Tylenol) are usually enough. We ask you to avoid NSAIDs like ibuprofen or naproxen for about two weeks on either side of the procedure so we don't blunt the response we're trying to encourage.
Light activity usually resumes within a week. Most patients notice gradual improvement over the first three months, with the full benefit assessed at around six months. BMAC is most often given as a single injection, sometimes repeated a year or more later if symptoms return.
Because the material comes from your own body, donor-related allergic, rejection, and disease-transmission risks are very low. Infection, contamination, bleeding, and other procedure-related risks remain possible. The most common issue is soreness at the harvest site, which is expected and self-limited, and bruising is common. Specific risks depend on the area being treated and are reviewed in detail before we proceed.
BMAC is not currently covered by insurance for orthopedic indications and is a cash-pay service. We'll give you clear pricing in advance so there are no surprises.
BMAC contains mesenchymal stromal cells — the cell type usually meant by "stem cells" in this context — along with platelets and growth factors. It is not a lab-expanded stem cell product, and it has not been FDA-approved to treat orthopedic conditions; its use for joints, tendons, and the spine remains investigational. Be cautious of any clinic promising an approved "stem cell therapy" for joint or tendon problems in the United States.
PRP is made from blood and is mostly platelets and plasma. BMAC is made from bone marrow and contains stromal cells, more white cells, and a different mix of growth factors in addition to platelets. BMAC is more biologically complex and a more involved procedure; whether it fits is decided from the diagnosis, prior response, the evidence, and your goals — not simply as a stronger version of PRP.
The area is numbed thoroughly with local anesthetic, and mild sedation is available. Most patients describe pressure rather than sharp pain during the harvest itself. The area is then sore for several days afterward — typically described as a deep bruise — and usually settles down within a week.
For well-selected tendon problems, a single course can give long-lasting relief. For arthritis, the evidence is still limited and results vary widely: when BMAC helps, relief may last several months to a year or more, but a lasting response is not guaranteed. Some patients elect a repeat injection. We'll reassess at three and six months and decide together based on how you're doing.
Not currently, for orthopedic indications. It is a cash-pay procedure. We'll go over costs clearly in advance and make sure it's the right step for you before scheduling.
Authoritative references on this topic, for patients who want to read further. These are educational resources, not medical advice.
Educational information only. This page describes BMAC in general terms. Whether it's appropriate for you depends on your history, exam, imaging, and treatment goals. The risks, benefits, alternatives, and expected results will be discussed in detail at your visit.
