Bone marrow concentrate & adipose cell therapy · Glastonbury, CT
When platelets alone are not enough signal for a degenerated joint, treatment moves to your own cells — harvested, concentrated and injected the same day, all under ultrasound guidance.
Quick answer
Cellular orthobiologics: BMAC (Bone-Marrow Aspirate Concentrate) and MFAT (Micronized Fat Adipose Tissue) are autoulgous stem cell treatments using cells taken from your own body — bone marrow concentrate from the pelvis or adipose-derived tissue from a small fat harvest — injected into a degenerated joint or tendon under ultrasound or fluoroscopic guidance. They deliver progenitor cells plus signaling proteins, a stronger biologic stimulus than PRP, and are used for moderate to advanced osteoarthritis, severe partial tears, and stubborn tendon disease.
Time in office
90 to 120 minutes
Anesthesia
Local, optional light sedation
Typical course
Usually one treatment
Return to desk work
1 to 3 days
First results
Weeks 6 to 16
Cell source
Your marrow or your fat
Donor tissue used
Never
Insurance
Not covered in the US
Definition
They are autologous cell-based treatments — your own marrow or adipose tissue, concentrated and returned to the injured joint in a single visit.
Bone marrow aspirate concentrate (BMAC) is drawn from the iliac crest and concentrated in office. It carries progenitor cells, platelets, and a dense mix of signaling proteins. Adipose-derived treatment (MFAT) uses a small, minimally invasive fat harvest, yielding a cell-rich graft that also provides mechanical cushioning inside the joint.
Both are performed and injected the same day, with nothing cultured, expanded or shipped to a laboratory.
IMPORTANT TO NOTE: Nothing from an outside prodcut or donor is used — no amniotic, umbilical or “off-the-shelf” product sold as live stem cells, because after commercial processing, NO "off-the-shelf" products contain ANY viable stem cells.
Indications
Generally reserved for joints and tendons where degeneration is too advanced for platelets alone.
Step by step
01
Dynamic ultrasound plus review of your imaging determines whether the joint has enough remaining structure to respond, and which cell source suits your case.
02
Marrow is aspirated from the iliac crest, or a small volume of fat is harvested through a minimally invasive technique. The site is thoroughly numbed first; this step takes 15 to 25 minutes.
03
The sample is concentrated in office while you rest. Nothing is cultured, expanded, frozen or sent to an outside laboratory.
04
The concentrate is placed into the joint and, where indicated, into surrounding ligament and tendon attachments under live ultrasound.
05
You leave with a staged plan: relative rest for several days, then progressive loading. Crutches are occasionally used for large weight-bearing joints.
06
Review at six weeks and again at three to four months with repeat ultrasound, comparing the joint against its baseline images.
Candidacy
Comparison
Frequently asked
The treatments use your own marrow or adipose tissue, which contains progenitor cells among many other components. The term "stem cell therapy" is used loosely in marketing; this practice describes procedures by what they actually are — autologous, same-day, minimally manipulated cell concentrates.
From you, on the day of your procedure — either your bone marrow or your own fat. Bottom line: The ONLY live stem cells must come from the patient: autologous. No embryonic cells, no donor tissue, and no amniotic or umbilical products are used, as NO "off-the-shelf" product contains any live stem cells. Any clinic or provider using those fake "stem cell" products are misleading patients with fraudulent treatment.
No responsible physician should promise cartilage regrowth. The realistic goals are reduced pain, improved function, slowed progression and deferred surgery. Imaging occasionally shows improved joint structure, but that is not the promise.
Cellular procedures cost more than PRP because of harvest time, processing and materials. Exact pricing is quoted in writing after your evaluation, once the target and volume are known. Nothing is charged before you have a written plan.
The harvest site is thoroughly anesthetized. Marrow aspiration produces brief deep pressure; fat harvest produces a pulling sensation. Most patients rate both as easier than expected, and light sedation is available.
Meaningful change usually begins between weeks six and sixteen and can continue improving for up to a year. Joints treated at a more advanced stage respond more slowly.
Usually yes. A second treatment is considered only when the first produced partial improvement and follow-up ultrasound suggests more can be gained.
Same-day autologous procedures using minimally manipulated tissue are performed under the practice of medicine rather than as FDA-approved drug products; BMAC and MFAT procedures are FDA-Cleared. Any clinic claiming FDA approval for a stem cell treatment is misrepresenting the regulatory position.
Sources
01
Mulvaney SW, Tortland PD, Shiple B, Curtis K. Regenerative medicine options for chronic musculoskeletal conditions: a review of the literature. Endurance and Sports Medicine. 2018.
02
Centeno CJ, et al. Symptomatic knee osteoarthritis treated with autologous bone marrow concentrate: registry outcomes at multi-year follow-up.
03
Hernigou P, et al. Bone marrow aspirate concentrate for osteonecrosis and osteoarthritis: cell dose and clinical outcome relationships.
04
Kim GB, et al. Adipose-derived cell therapy for knee osteoarthritis: systematic review of clinical outcomes and safety.
05
American Academy of Orthopaedic Surgeons. Position statement on the use of orthobiologics in musculoskeletal care.
06
OrthoBiologics Ethics Consortium. Consensus principles for ethical research, marketing and clinical use of orthobiologics.
This page is written for patient education and does not constitute medical advice or establish a physician-patient relationship. Treatment decisions require an in-person examination. Orthobiologic procedures are not FDA-approved drug therapies; they are performed as autologous same-day procedures under the practice of medicine. Dr. Tortland reports no financial interest in the products or devices described on this page.
Cellular treatment is only worth doing when ultrasound and imaging show the joint has something to work with. One evaluation gives you that answer.