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Bone Marrow Aspirate Concentrate (BMAC)Therapy

When PRP and Cortisone Haven’t Been Enough: A Deeper Regenerative Option

Some patients arrive at our door after trying everything: physical therapy, cortisone shots, PRP, gel injections, and still living with bone-on-bone knee pain or a hip that limits every step. If that sounds familiar, BMAC (bone marrow aspirate concentrate) therapy may be the next conversation worth having. This procedure draws concentrated regenerative tissue cells and growth factors directly from your own bone marrow and delivers them precisely to the damaged joint or tissue.

At The Osteopathic Center for Healing, we work with patients from Rockville, Bethesda, Potomac, and Gaithersburg who are serious about avoiding surgery but need something more targeted than a first-line injection. If you’ve been searching for “advanced non-surgical knee treatment Rockville,” “orthopaedic alternative to knee replacement Bethesda,” or “bone-on-bone knee pain treatment without surgery near me,” this page is for you.

Bone Marrow Aspirate Concentrate (BMAC)Therapy

When Is BMAC Therapy Recommended?

Dr. Spiegel uses BMAC for the same category of conditions as adipose autograft therapy: cartilage degeneration, osteoarthritis, and labral injuries, but typically when the degree of degeneration is more advanced or when a deeper regenerative response is needed. Because osteoarthritis is simply the medical term for joint degeneration, BMAC applies to any joint in the body where that process is occurring.

  • Knee osteoarthritis: moderate to advanced cartilage loss, bone-on-bone discomfort, or failed prior treatments including PRP
  • Hip osteoarthritis and degeneration: significant joint space narrowing, chronic pain, and reduced range of motion
  • Shoulder osteoarthritis and labral injuries: cartilage wear, labral tears, or post-injury joint degeneration
  • Hip labral tears: deep joint instability and cartilage involvement that hasn’t responded to other treatments
  • Ankle and wrist joint degeneration: post-traumatic or age-related arthritis in smaller joints
  • Facet joint degeneration: osteoarthritis of the spine’s facet joints causing localized or referred pain
The key distinction: if joint degeneration and cartilage loss are driving your pain, in any joint, BMAC may be the most appropriate tool, particularly when a first-line option like PRP hasn’t delivered sufficient relief. Patients throughout Rockville, Bethesda, Potomac, and Gaithersburg can schedule a consultation with Dr. Spiegel to review imaging and determine whether BMAC is the right next step.

BMAC vs. PRP: What’s the Difference?

This is one of the most common questions from patients researching regenerative options. The distinction Dr. Spiegel makes is primarily clinical: PRP is best suited for tendon injuries and soft tissue conditions, while BMAC, like adipose autograft therapy, is reserved for cartilage degeneration, osteoarthritis, and labral injuries. Within that cartilage-focused category, BMAC is typically used when degeneration is more advanced or when prior treatments haven’t delivered enough benefit. Neither therapy is universally superior. The right choice depends entirely on your diagnosis, imaging findings, and treatment history. Dr. Spiegel will walk you through both options.

How BMAC Therapy Works

Using image guidance and local anesthesia, a small sample of bone marrow is collected from the posterior iliac crest, the back of your pelvic bone. The aspirate is then processed in a centrifuge to concentrate the regenerative cells and growth factors. This concentrated preparation is injected precisely into the affected joint, tendon, or tissue using real-time imaging to ensure accuracy. The entire procedure is performed in-office on a same-day basis and typically takes under two hours from start to finish.

What to Expect

  • In-office procedure under local anesthesia, no hospital stay
  • Mild soreness at the bone marrow collection site (back of the pelvis) and injection site for several days
  • Minimal downtime: most patients resume light activity within a few days
  • The healing and regenerative process continues over weeks to months following the injection
Individual recovery timelines and outcomes vary. Dr. Spiegel will set appropriate expectations based on your specific diagnosis, imaging, and overall health.

Can BMAC Help Me Avoid Knee Replacement?

Research published through 2025 suggests BMAC may provide meaningful short- to mid-term improvement in pain and function for selected patients with knee osteoarthritis. Orthobiologic treatments, including BMAC, are offered in select orthopedic and sports medicine practices and continue to be studied at major academic medical centers to better define their role in knee osteoarthritis care. Source: https://www.nature.com/articles/s41598-024-51410-2 

Why The Osteopathic Center for Healing

  • Board-certified physician with advanced regenerative protocols tailored to your individual diagnosis and imaging
  • Image-guided collection and injection for precision and patient safety
  • Collaborative care: we combine BMAC with physical therapy and other supportive treatments when appropriate
  • Convenient access for patients in Rockville, Bethesda, Potomac, and Gaithersburg, MD

Frequently Asked Questions About BMAC

BMAC stands for bone marrow aspirate concentrate. It refers to the process of drawing bone marrow from the patient, concentrating the regenerative cells via centrifuge, and injecting the result into a damaged joint or tissue area.
BMAC is an autologous regenerative therapy that uses a concentrated preparation of your own bone marrow, including regenerative tissue cells and growth factors, processed and reinjected the same day. It is not a cultured, expanded, or donor-derived product. Some patients search for this type of procedure using other terms; BMAC is the clinically accurate description of what we offer.
PRP is typically the first regenerative option for mild to moderate conditions. BMAC contains a broader concentration of regenerative tissue cells and growth factors drawn from bone marrow, and is often considered when PRP hasn’t provided adequate relief or the condition is more advanced. Dr. Spiegel will recommend the approach that fits your specific situation.
The area is numbed with local anesthesia before collection. Most patients experience pressure and mild discomfort during the procedure, followed by soreness at the collection site for a few days, similar to the feeling after a blood draw in the pelvis.
Clinical studies to date suggest short- to mid-term improvement for many patients, with some individuals maintaining benefit for a year or more. Long-term data continues to emerge. Dr. Spiegel will discuss realistic expectations based on your diagnosis.
BMAC is generally not covered by most insurance plans and is typically an out-of-pocket expense. Our team can discuss costs and available options before your procedure.
The information on this page is intended for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Only a qualified healthcare provider who has reviewed your imaging and medical history can determine whether BMAC is appropriate for you.

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