Bone marrow aspirated from the iliac crest can be processed in a laboratory setting to create a bone marrow concentrate and then used in various musculoskeletal applications. Studies and experience have shown that BMC may be affective in treating long- bone fractures that won’t heal (non-unions), Avascular Necrosis, osteoarthritis, and a myriad of soft tissue injuries. Our increasing experience is providing evidence that the mesenchymal stem cells in the bone marrow are capable of mitigating the inflammatory response and thereby down-regulate pain.
A 36-year-old woman started experiencing left hip pain particularly after exercise. She was a runner and had to quit because of the hip pain. After a plain X-ray was “negative”, a left hip MRI arthrogram injection with fluoroscopy was compatible with a diagnosis of a small, non-detached mid-posterior labral tear. Rectus muscle tendon inflammation at its origin was additionally noted. The usual MRI findings of a para labral cyst, arthritis of the hip joint, Avascular Necrosis of the femoral head, stress fracture, and loose bodies were absent.
Bone marrow was aspirated from her posterior superior iliac crest and concentrated in our laboratory followed by removal of the RBCs. 45 minutes later, under fluoroscopic control, 5 CCs of the patient’s concentrated bone marrow was injected into the left hip.
At eight weeks post treatment, the patient returned to her vigorous daily fitness routine. At 12 weeks post treatment, she started her daily outdoor runs working up to 6 to 12 miles per day, depending on time constraints. At 16 weeks post treatment, she ran a marathon.
In 2005, Aggarwal and Pittenger published a scientific article in a peer-reviewed journal, ” Human mesenchymal stem cells modulate allogenic immune responses”. Basically, the images seen on an X-ray or MRI are only part of the explanation as to what is behind pain generation in an effected joint.
There are patient factors that affect bone marrow collection and the quantity and quality of adult mesenchymal stem cells contained therein. While there are technical factors influenced by surgeon techniques of harvesting, bone marrow volume collection is influenced by a patient who smokes, a woman going through her menstrual cycle, certain medications and neutriceuticals, and patient age, with young adults having the highest number of progenitor cells.
To learn more about your painful joint and the role of bone marrow concentrate in treatment, review my web site or ask me.
Mitchell B. Sheinkop, M.D.
1565 North LaSalle Street . Chicago . Illinois . 60610