Bone Marrow Aspiration Concentrate in the Treatment of Osteoarthritis: A Review of its Current Clinical Application

Background: Bone marrow aspiration concentrate (BMAC) has gained acceptance as a safe orthobiologic for treating osteoarthritis (OA), despite lacking robust supporting evidence. Although several publications have documented the use of BMAC in OA, evidence confirming its unequivocal efficacy remains limited. Methods: This review aims to summarize the current clinical evidence regarding BMAC as a therapeutic for OA, while also presenting the author’s perspective. Sixteen studies were reviewed, including ten randomized clinical trials (RCTs) and six cohort studies. Results: From the review of existing literature, BMAC injections do not appear to significantly improve pain and function compared to conventional therapies such as hyaluronic acid and corticosteroids, although some studies report a longer duration of effectiveness. Furthermore, the evidence for structural improvement, which was the original rationale for cell therapy, is seldom reported. Conclusion: In light of these findings, it is suggested that high-quality data from a large patient cohort is needed to determine the role of BMAC injections in OA treatment and address reimbursement issues. From the author’s perspective, the introduction of a national registry system that provides valuable information on the cost-effectiveness of various orthopedic procedures may offer a solution.