Summary

Bone marrow aspirate concentrate to treat musculoskeletal disorders

Abstract

Objective

To understand the stages and characteristics of BMAC processing, use and
mechanisms of action in humans to treat musculoskeletal disorders. Design: A
systematic review of the literature was completed in April 2018. Studies were selecte
from the PubMed, Lilacs and Cochrane databases. The following search terms were
used in the review query: "Bone marrow aspirate concentrate or bmac"; "bone marrow
aspirates concentrate or bmac and humans" and "bone marrow aspirates concentrate or
bmac and humans and musculoskeletal" and "bone marrow aspirates concentrate or
bmac and humans and musculoskeletal and orthopedics". Results: After thorough
review, 13 studies were included in the review. These articles revealed that BMAC was
used to treat cartilage damage, traumatic musculoskeletal injuries, pseudoarthrosis,
osteonecrosis, among other pathologies. Patients' ages ranged from 15 to 68 years. The
preferred aspiration site was the iliac crest region under anesthesia. 60 ml syringes and
11 mm needles were most widely used for BMAC collection, and, after processing,
most studies noted that 5 ml of aspirate fluid was used for treatment. The aspirate was
processed via centrifugation for 12 to 17 minutes at a speed of 3200 rpm. The reviewed
articles noted BMAC was effective in the treatment of osteochondral lesions of the knee
(P = 0.01) and cited mitigation of pain caused by osteoarthritis. It was not found to be
effective in the treatment of infected or uninfected pseudoarthrosis. Complications were
found to be mild and uncommon. Conclusion: Most studies concluded BMAC to be
effective treatments for select musculoskeletal pathologies with minimal complications.