What is put into my sore joint?

What does marrow concentrate mean?

Bone marrow aspirate concentrate means marrow taken through a needle from your pelvis, then processed into a smaller portion. Here, aspirate simply means the marrow that was taken out.

The finished shot contains a mixture of cells and other parts of marrow. That matters because the name doesn't promise one measured kind of cell in the syringe.

The pelvis and the sore joint are separate areas that need aftercare. Ask what soreness is expected in each area and get a number for concerns before leaving the clinic.

What will QC Kinetix explain during the visit?

QC Kinetix can discuss regenerative treatments, meaning non-surgical shots prepared there from your blood or marrow. The clinician examines the joint, reviews past care and asks what daily task hurts.

You'll hear what is collected, where it is taken and how it is processed. Ask about visit time, aftercare and whom to call if the soreness rises.

How are PRP and marrow choices different?

PRP contains a platelet-rich portion separated from your blood, while marrow concentrate comes from your pelvis. They aren't the same shot, even though both begin with tissue from you.

Ask why one treatment suits the findings from your joint exam better than another. Before deciding, get the full cost, follow-up schedule and next step if nothing improves.

Sources

1. In 96 patients, concentrated bone marrow aspirate contained a mean of 26.3 million nucleated cells per mL but only about 1,422 colony-forming units of connective tissue progenitors, and the nucleated cell count had negligible predictive value for how many progenitor cells were actually present (r-squared 0.28).

   Muench LN, et al. — Nucleated Cell Count Has Negligible Predictive Value for the Number of Colony-Forming Units for Connective Tissue Progenitor Cells (Stem Cells) in Bone Marrow Aspirate Harvested From the Proximal Humerus During Arthroscopic Rotator Cuff Repair. Arthroscopy, 2021. DOI: 10.1016/j.arthro.2021.01.064.

2. Mesenchymal stromal cells make up only about 0.001 to 0.01 percent of the nucleated cells in bone marrow, so the harvesting and processing technique - aspiration site, syringe size, centrifuge speed and time - materially determines what ends up in the syringe, and no consensus protocol exists.

   Jeyaraman M, et al. — Impact of the Process Variables on the Yield of Mesenchymal Stromal Cells from Bone Marrow Aspirate Concentrate. Bioengineering (Basel), 2022. DOI: 10.3390/bioengineering9020057.

3. The International Society for Cell & Gene Therapy position statement holds that the acronym MSC should mean mesenchymal STROMAL cells and should only be called stem cells where rigorous in vitro and in vivo evidence of stemness exists for that specific preparation.

   Viswanathan S, et al. — Mesenchymal stem versus stromal cells: International Society for Cell & Gene Therapy (ISCT®) Mesenchymal Stromal Cell committee position statement on nomenclature. Cytotherapy, 2019. DOI: 10.1016/j.jcyt.2019.08.002.

4. The 2005 International Society for Cellular Therapy statement that first flagged the problem concluded that plastic-adherent marrow cells do not meet generally accepted criteria for stem cell activity, making the name 'mesenchymal stem cell' scientifically inaccurate and potentially misleading to the lay public.

   Horwitz EM, et al. — Clarification of the nomenclature for MSC: The International Society for Cellular Therapy position statement. Cytotherapy, 2005. DOI: 10.1080/14653240500319234.

5. A laboratory study of three commercially available amniotic fluid products marketed for orthopedic use found no viable mesenchymal stem cells in any of them when compared against unprocessed amniotic fluid and bone marrow-derived MSC samples - products sold as 'amniotic stem cell therapy' contained no living stem cells.

   Panero AJ, et al. — Are Amniotic Fluid Products Stem Cell Therapies? A Study of Amniotic Fluid Preparations for Mesenchymal Stem Cells With Bone Marrow Comparison. Am J Sports Med, 2019. DOI: 10.1177/0363546519829034.

6. A meta-analysis of 10 studies and 472 patients comparing bone marrow aspirate concentrate with adipose stromal vascular fraction for knee osteoarthritis found both improved pain scores and could not establish that either is superior to the other.

   Bolia IK, et al. — Clinical Efficacy of Bone Marrow Aspirate Concentrate Versus Stromal Vascular Fraction Injection in Patients With Knee Osteoarthritis: A Systematic Review and Meta-analysis. Am J Sports Med, 2022. DOI: 10.1177/03635465211014500.

7. The 2018 AAOS/NIH consensus work group recommended that minimally manipulated mixed cell preparations be called CELL THERAPY rather than stem cell therapy, and that their untested and uncharacterised nature be clearly communicated to patients and the public, because stem cells have properties these preparations do not meet.

   Chu CR, et al. — Optimizing Clinical Use of Biologics in Orthopaedic Surgery: Consensus Recommendations From the 2018 AAOS/NIH U-13 Conference. J Am Acad Orthop Surg, 2019. DOI: 10.5435/JAAOS-D-18-00305.

8. On 27 September 2024 the Ninth Circuit held in United States v. California Stem Cell Treatment Center that stromal vascular fraction produced by enzymatically digesting a patient's own fat IS a drug under the Federal Food, Drug, and Cosmetic Act, and that the same surgical procedure exception does not apply because the removed fat and the implanted SVF are not the same thing. The district court's ruling for the clinics was reversed.

   United States Court of Appeals for the Ninth Circuit — United States v. California Stem Cell Treatment Center, Inc., No. 22-56014 (9th Cir. Sept. 27, 2024). , 2024.