Bone marrow functions as the “nursery” where all our blood cells come from.  Within this tissue, are multiple types of stem cells, but the mesenchymal stem cell, or MSC, has the most promise as an agent of healing.  The MSC is a multi potent cell which can transform into ligament, cartilage, or bone, depending on its surrounding environment.  The mesenchymal stem cell also produces an anti-inflammatory effect. The pericyte is another primitive type of mesenchymal stem cell that surrounds the small blood vessels in bone and other tissues. The pericyte is thought to be the precursor of the MSC. One in 10,000 cells in the bone marrow is a mesenchymal stem cell. A typical yield for the number of stem cells in a bone marrow derived procedure is about 30-60,000 MSCs.

Bone marrow is usually obtained from the iliac crest area of the hip using a special needle. The marrow is then concentrated in a special centrifuge to yield bone marrow aspirate concentrate (BMAC). In a BMAC procedure, pain relief is not only because of the stem cells, but also because of a very potent concentration of anti-inflammatory cytokines present within the BMAC itself. Cytokines are small proteins released by cells. They have a specific effect on the interactions and communications between cells. They are often either pro-inflammatory or anti-inflammatory in nature. The special processing of the bone marrow to create BMAC results in the anti-inflammatory cytokines being in a much larger concentration than the pro-inflammatory cytokines. It is a published fact that if the ratio of an important anti-inflammatory cytokine know as IL1-ra exists in a concentration 10 times greater that the most potent pro-inflammatory cytokine known as IL1-beta, then there will be a favorable anti-inflammatory and healing response in the area. Our processing has been shown to cause the ratio of IL1-ra/IL1-beta to be potentially as high as 500/1(!)