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Bone Marrow Aspirate (BMA)


BMA is derived from a patient's bone marrow. It contains a heterogeneous mix of white blood cells—including stem cells, progenitor cells, lymphocytes and granulocytes—and platelets.
Stem Cells Progenitor Cells Lymphocytes Granulocytes Monocytes/Macrophages Platelets

Stem Cells

Have the potential to convert to osteoblasts, chondrocytes and other terminal tissue types1,2,3,4,5,6
Stem cells differentiate into many different types of cells. There are several types of stem cells, including hematopoietic and mesenchymal. They vary in differentiation potential and the terminal cell types they can become.
  • Hematopoietic stem cells (HSCs) differentiate into blood cell components.
  • Mesenchymal stem cells (MSCs) have the capability to differentiate into many different cell types responsible for repair or growth of bone, cartilage, muscle, tendons, ligaments and connective tissue.

Progenitor Cells

Convert to terminal tissue; support angiogenesis; release BMP-2 and BMP-6; activate dormant cells
Endothelial progenitor cells also retain the ability to differentiate into other cell types, but to a lesser extent than stem cells. Progenitor cells are capable of releasing bone morphogenetic protein 2 (BMP-2) and BMP-6, two bone morphogenetic proteins that play a role in bone formation.7,8,9

Lymphocytes

Support the migration and proliferation of endothelial progenitor cells
Lymphocytes are small white blood cells that play a large role in immune response by protecting the body from disease. Lymphocytes also support the growth of endothelial progenitor cells, which can stimulate angiogenesis, release BMP-2 and BMP-6 and up-regulate the production of BMP-2.10

Granulocytes

Support angiogenesis through release of vascular endothelial growth factors (VEGF); mediate inflammation
Granulocytes are a type of white blood cell filled with granules that digest microorganisms. Granulocytes release growth factors that support the development of new blood vessels (angiogenesis) necessary to support tissue regeneration and bone formation.11,12

Monocytes/Macrophages

Monocytes assist in pathogen recognition and eventually become macrophages, which engulf and destroy pathogens as well as playing a critical role in tissue regeneration and repair.13

Platelets

Rich source of growth factors that support proliferation and differentiation
Platelets are rich in growth factors, which play a critical role in the process of stem cell differentiation. Growth factors instruct stem cells to differentiate through proteins, which bind to receptors on the surface of the cell. A signal is delivered to the nucleus to turn off or turn on certain genes, which generates the proteins that dictate cell differentiation.14,15

Discover the healing power of bone marrow stem cells in our latest infographic.

  • Composition
  • Mechanism of action
  • Potential

For medical inquiries, please contact medical affairs.

The Differentiation Potential of Stem Cells and Progenitor Cells5,16





Make the Shift to a Less Invasive Approach

There has been a shift from traditional repair surgery to more sophisticated methods, including less invasive surgical techniques and the use of biologics.
Iliac crest autograft is a highly invasive procedure performed in the operating room that can generate significant donor site morbidity. In contrast, concentrated BMA provides a less invasive solution that can be performed quickly and easily.17

Discover the Benefits of Concentrating BMA



High Cell Concentration Counts


Concentrated BMA is high in HSCs and MSCs, which are known to be vital to biological processes such as bone formation and the regeneration of tissue, including:1,2,3,18
  • Cartilage
  • Muscle
  • Marrow
  • Tendons
  • Ligaments
MSCs in concentrated BMA have the potential to:19
  • Enhance the normal healing response
  • Self-renew
  • Undertake clonal expansion
  • Differentiate into different musculoskeletal tissues
  • Play an immunomodulatory role




Concentrated BMA Delivers High Cell Counts and Clinical Success

It’s easy enough to obtain BMA, but why concentrate it? Concentrated BMA delivers growth factors and highly concentrated stem cells and progenitor cells directly to the application site, harnessing the body's biological potential. Concentrating bone marrow results in high cell counts, which ultimately provides more healing cells to the affected area. A higher number of total nucleated cells is directly correlated to clinically successful bone regeneration.17,20,21,22

1Matsumoto T, Kawamoto A, Kuroda R, et al. Therapeutic potential of vasculogenesis and osteogenesis promoted by peripheral blood CD34-positive cells for functional bone healing. Am J Pathol. 2006;169(4):1440-1457.

2Matsumoto T, Mifune Y, Kawamoto A, et al. Fracture induced mobilization and incorporation of bone marrow-derived endothelial progenitor cells for bone healing. J Cell Physiol. 2008;215(1):234-242.

3Mifune Y, Matsumoto T, Kawamoto A, et al. Local delivery of granulocyte colony stimulating factor-mobilized CD34-positive progenitor cells using bioscaffold for modality of unhealing bone fracture. Stem Cells. 2008;26(6):1395-1405.

4McArdle A. Manipulation of stem cells and their microenvironment for tissue engineering. Surgery: Current Research. 2013;03(03).

5Caplan A. Mesenchymal stem cells: the past, the present, the future. Cartilage. 2010;1(1):6-9.

6Caplan A. What's in a name? Tissue Engineering Part A. 2010;16(8):2415-2417.

7Jung Y, Song J, Shiozawa Y, et al. Hematopoietic stem cells regulate mesenchymal stromal cell induction into osteoblasts thereby participating in the formation of the stem cell niche. Stem Cells. 2008;26(8):2042-2051.

8Kuroda R, Matsumoto T, Kawakami Y, Fukui T, Mifune Y, Kurosaka M. Clinical impact of circulating CD34-positive cells on bone regeneration and healing. Tissue Engineering Part B: Reviews. 2014;20(3):190-199.

9El Khassawna T, Serra A, Bucher C, et al. T Lymphocytes influence the mineralization process of bone. Front Immunol. 2017;8:562.

10Ono T, Okamoto K, Nakashima T, et al. IL-17-producing γδ T cells enhance bone regeneration. Nat Commun. 2016;7:10928.

11Kusumanto Y, Dam W, Hospers G, Meijer C, Mulder N. Platelets and granulocytes, in particular the neutrophils, form important compartments for circulating vascular endothelial growth factor. Angiogenesis. 2003;6(4):283-287.

12Seignez C, Phillipson M. The multitasking neutrophils and their involvement in angiogenesis. Curr Opin Hematol. 2017;24(1):3-8.

13Das A, Sinha M, Datta S, et al. Monocyte and macrophage plasticity in tissue repair and regeneration. Am J Pathol. 2015;185(10):2596-2606.

14Amable P, Carias R, Teixeira M, et al. Platelet-rich plasma preparation for regenerative medicine: optimization and quantification of cytokines and growth factors. Stem Cell Res Ther. 2013;4(3):67.

15Ríos D, López C, Carmona J. Platelet-rich gel supernatants stimulate the release of anti-inflammatory proteins on culture media of normal equine synovial membrane explants. Vet Med Int. 2015;2015:547052.

16Neuringer I, Randell S. Stem cells and repair of lung injuries. Respir Res. 2004;5(1):6.

17Hernigou P, Poignard A, Manicom O, Mathieu G, Rouard H. The use of percutaneous autologous bone marrow transplantation in nonunion and avascular necrosis of bone. J Bone Joint Surg Br. 2005;87(7):896-902.

18Tondreau T, Meuleman N, Delforge A, et al. Mesenchymal stem cells derived from CD133-positive progenitor cells using bioscaffold for modality of unhealing bone fracture. Stem Cells. 2008;26(6):1395-1405.

19Imam M, Mahmoud S, Holton J, Abouelmaati D, Elsherbini Y, Snow M. A systematic review of the concept and clinical applications of bone marrow aspirate concentrate in orthopaedics. SICOT J. 2017;3(17):1-8.

20Marx R, Harrell D. Translational research: The CD34+ cell is crucial for large-volume bone regeneration from the milieu of bone marrow progenitor cells in craniomandibular reconstruction. Int J Oral Maxillofac Implants. 2014;29(2):e201-e209.

21Johnson R. Bone marrow concentrate with allograft equivalent to autograft in lumbar fusions. Spine. 2014;39(9):695-700.

22Desai P, Hasan S, Zambrana L, et al. Bone mesenchymal stem cells with growth factors successfully treat nonunions and delayed unions. HSS Journal. 2015;11(2):104-111.




Risk Information: These procedures require needle access, possibly resulting in discomfort, tenderness, bruising, swelling, bleeding or pain at the access site, at which there is a small risk of infection. Lightheadedness, fainting, nausea or vomiting may occur. Before any medical procedure, review prescription and nonprescription medications and any natural or herbal remedies your patient is taking or plans to take.

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