Bone Marrow Basics
This is the most common site for bone marrow aspiration.
What is the posterior iliac?
This blood-derived product contains platelets but no notable stem cells.
What is PRP?
BMAC is often recommended when this happens to a patient’s response to PRP treatments.
What is failure to achieve adequate improvement or PRP non-response?
The Hernigou technique emphasizes using this number of small-volume draws to maximize cell concentration.
What is multiple small draws of 1–2 mL each? For XCELL, filling 6, 10mL syringes.
MSCs from bone marrow aspirate are present in this amount relative to total nucleated cells.
What is less than 0.01%?
These are the two major stem cell types found in bone marrow.
What are hematopoietic stem cells and mesenchymal stem cells?
This autologous product can be preferred for moderate to severe joint degeneration.
What is BMAC?
BMAC is frequently used for this type of joint condition, especially in patients who are not surgical candidates.
What is osteoarthritis?
To reduce dilution with peripheral blood, the needle should be repositioned after approximately this much aspirate is collected.
What is every 1–2 mL?
True or False: Injected MSCs directly turn into new cartilage cells in the joint.
What is false? (They act primarily via paracrine signaling.)
This physiological factor increases with each subsequent mL drawn from the same site and can dilute the cellular quality of the aspirate.
What is peripheral blood contamination?
Compared to PRP, BMAC contains more of these immunomodulatory cells.
What are monocytes (or WBCs)?
This class of patients may not be ideal for BMAC due to lower stem cell yield and bone marrow quality.
Who are elderly patients or patients with systemic inflammatory diseases?
This part of the iliac crest provides access to the hematopoietic-rich marrow targeted in the Hernigou method.
What is the posterior superior iliac spine (PSIS)?
This is the primary mechanism by which MSCs support tissue repair.
What is paracrine signaling or immunomodulation?
These cells make up less than 0.01% of total nucleated cells in BMA but are highly valued in regenerative medicine.
What are mesenchymal stem cells (MSCs)?
Unlike PRP, BMAC contains these progenitor cells that can differentiate into osteoblasts, chondrocytes, and adipocytes.
What are mesenchymal stem cells (MSCs)?
BMAC is often recommended for early to moderate osteoarthritis because of this added biologic advantage.
What is the presence of stem cells and greater anti-inflammatory signaling?
This strategy enhances MSC yield by rotating the needle tip and changing depth during aspiration.
What is redirecting or repositioning the needle in multiple trajectories?
This U.S. agency governs how minimally manipulated autologous stem cells can be used.
What is the FDA?
This measurement is commonly used to quantify the concentration of cells in BMA samples, especially after processing.
What is total nucleated cell count (TNC)?
This component, present in higher levels in BMAC than PRP, contributes to its stronger immunomodulatory effects by influencing macrophage polarization.
What are mononuclear cells (MNCs)?
BMAC may be especially useful in patients with long-standing joint degeneration because of its ability to influence this cellular process that drives cartilage loss.
What is catabolic signaling or the inflammatory cascade?
The XCELL BMAC kit follows Hernigou’s method by providing this design feature of the Jamshidi, to support high-yield aspirate collection.
What is a multi-port aspiration cannula (or fenestrated side holes)?
This is the FDA’s product classification number for minimally manipulated autologous bone marrow aspirate.
What is 361 (HCT/P)?