When the Wear Runs Deeper
You've done the physical therapy, the cortisone, maybe even PRP, and your knee or hip still stops you. BMAC uses your own bone marrow, concentrated in the office and placed into the joint with ultrasound, as a stronger regenerative option for more advanced arthritis.
Not ready to book? Start with a free 15-minute call
What Is BMAC Therapy?
BMAC (bone marrow aspirate concentrate) therapy collects a small amount of a patient's own bone marrow from the back of the pelvic bone, concentrates it in a centrifuge and injects it under ultrasound guidance into a joint with moderate to advanced osteoarthritis, cartilage loss or labral damage. At the Osteopathic Center for Healing in Rockville, MD, Dr. Neil Spiegel, DO, MBA performs it in the office in a single visit, usually in under two hours.
What's Inside BMAC?
Bone
It starts with your own bone, usually the back of your pelvic bone.
Marrow
The soft tissue inside the bone, rich in growth factors and healing cells.
Aspirate
The marrow is drawn out with a needle.
Concentrate
It's spun in a centrifuge so the parts that support healing are packed into a smaller amount.
Everything comes from your own body and goes back in the same day.
Where Does BMAC Fit in Your Options?
Joint care usually moves up in steps. BMAC sits near the top.
Physical Therapy and Movement
The first step for most joints.
Cortisone or Gel Shots
Short-term relief.
PRP
Best for tendons and early joint wear. About PRP
Adipose or BMAC
For worn cartilage and arthritis. BMAC is often used when the wear is more advanced or PRP wasn't enough.
Surgery
When the joint needs replacing.
Not everyone goes in this order. Dr. Spiegel looks at your imaging and history and tells you where you are on it.
Who Is BMAC For?
- Moderate to advanced knee, hip or shoulder arthritis
- "Bone on bone," or narrowing on your X-ray or MRI
- PRP, cortisone or gel shots didn't give you enough relief
- You want to put off a joint replacement, or you aren't a candidate right now
Which Joints Do We Treat?
Tendon or ligament injury? See joint and tendon injuries.
How Does BMAC Compare to Adipose and PRP?
| Best For | Source | |
|---|---|---|
| PRP | Tendons, ligaments, early joint wear | Your blood |
| Adipose | Worn cartilage, arthritis, labral damage | Your fat |
| BMAC | More advanced arthritis, or when PRP wasn't enough | Your bone marrow |
None of them is better across the board. The right one depends on your diagnosis, imaging and what you've already tried. Learn about adipose therapy and PRP.
What Happens on Procedure Day?
Everything happens in our Rockville office, with no hospital and no general anesthesia.
Usually under two hoursNumbing
Local anesthetic over the back of your pelvic bone.
Collection
Dr. Spiegel uses ultrasound to guide a needle into the bone and draws a small amount of marrow.
Concentrating
The marrow is spun in a centrifuge in the office.
Ultrasound-Guided Injection
The concentrate is placed precisely into the joint.
Home the Same Day
You go home after your visit.
Does Bone Marrow Collection Hurt?
This is the question we hear most. The area is numbed first, and most people describe deep pressure more than sharp pain. Expect soreness at the back of your hip for a few days.
What Are Recovery and Results Like?
First Few Days
Soreness at the collection site and in the joint. Light activity within a few days.
Weeks to Months
Improvement builds gradually as your body responds.
What the Research Says
Studies suggest BMAC can improve pain and function in the short to medium term for some people with knee osteoarthritis. Research is still ongoing to define who benefits most.
Scientific Reports, 2024BMAC isn't a guaranteed alternative to surgery. Dr. Spiegel will tell you plainly whether you're a good candidate.
Why Choose Dr. Spiegel?
What Do People Ask About BMAC?
What Does BMAC Stand For?
Bone marrow aspirate concentrate. Aspirate means the marrow is drawn out with a needle, and concentrate means it's spun in a centrifuge so the parts that support healing are packed into a smaller amount.
Do I Need an MRI First?
Not always. Dr. Spiegel starts with an exam and ultrasound here in the office. If those don't tell the whole story, he'll order an MRI or other diagnostic testing, or refer you to get it. If you already have imaging, bring it.
Does BMAC Use My Own Cells?
Yes. Everything comes from your own bone marrow and is used in the same visit. Nothing is grown in a lab.
How Is BMAC Different From PRP?
PRP comes from your blood and is best for tendons and soft tissue. BMAC comes from bone marrow and is usually used for more advanced joint wear.
How Is BMAC Different From Adipose Therapy?
Both are used for arthritis and cartilage loss. Dr. Spiegel chooses between them based on your joint, how much damage there is and your health history.
Is the Bone Marrow Collection Painful?
The area is numbed first. Most people feel deep pressure during the collection and some soreness at the back of the hip for a few days.
How Long Do BMAC Results Last?
It varies. Some people feel better for a year or more, and others benefit from a follow-up treatment.
Is BMAC Covered by Insurance?
Most plans don't cover it. We'll go over costs at your consult.
Request an Appointment
Tell us about your joint and what you've tried so far, and our team will reach out to schedule your consult.
See if BMAC Is Your Next Step
Book a consult with Dr. Spiegel in Rockville, MD and bring your imaging.
Not ready to book? Start with a free 15-minute call