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Concentrated Bone Marrow Aspirate (CBMA)

Concentrated Bone Marrow Aspirate (CBMA)

CBMA has many of the growth factors found in PRP but it also has mesenchymal stem cells and a very potent anti-inflammatory interleukin receptor antagonist protein (IRAP). CBMA is used in similar conditions as listed for PRP, but it has the added benefit of stem cells. The old thought of a stem cell being injected and turning into the body part I was injected into has evolved. We now know that stem cells help activate macrophages or white blood cells to produce a secrotome. It is this secrotome that is tissue specific and promotes local cell turnover. Thus, the presence of growth factors, stem cell producing secretomes and IRAP make CBMA a very attractive orthobiologic. 

Conditions where we use CBMA:

Tendinopathies and Tendon tears

  • Upregulates tenocyte production and promotes homogenous tendon repair when combined with appropriate mechanical stimulis
  • Achilles tendon, Posterior tibial tendon, Peroneal tendon, Extensor/Flexor Hallucis tendon repairs are all augmented now with CBMA with excellent long-term outcomes

Bone

  • CBMA upregulates endochondral temporal cascade through TGF-beta mediated growth factors
  • Used in Jones fracture, delayed unions, non-unions, stress reactions, stress fractures and has shown excellent clinical outcomes

Bone Marrow Aspirate Concentrate in Animal Long Bone Healing: An Analysis of Basic Science Evidence

Percutaneous internal fixation of proximal fifth metatarsal jones fractures (Zones II and III) with Charlotte Carolina screw and bone marrow aspirate concentrate: an outcome study in athletes

The effect of concentrated bone marrow aspirate in operative treatment of fifth metatarsal stress fractures; a double-blind randomized controlled trial

Cartilage

  • CBMA reduces the catabolic load on cartilage by reducing metalloproteinases or enzymes that are destructive to cartilage
  • A potent anti-inflammatory effect is mediated by IRAP
  • CBMA upregulates collagen production and stimulates synoviocytes (cells in the joint) to produce joint sparing proteins including hepatocytes and hyaluronic acids (HAs)
  • CBMA has also been used to augment osteochondral repair and replacement as well as provide a biologic milieu in arthritic joints

Biological Effects of Bone Marrow Concentrate in Knee Pathologies

Concentrated Bone Marrow Aspirate May Decrease Postoperative Cyst Occurrence Rate in Autologous Osteochondral Transplantation for Osteochondral Lesions of the Talus

Arthroscopic Bone Marrow Stimulation and Concentrated Bone Marrow Aspirate for Osteochondral Lesions of the Talus: A Case-Control Study of Functional and Magnetic Resonance Observation of Cartilage Repair Tissue Outcomes

The Treatment of Osteochondral Lesions of the Talus with Autologous Osteochondral Transplantation and Bone Marrow Aspirate Concentrate: Surgical Technique

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