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Why Differences in Bone Marrow Aspirate Techniques Matter!

In a previous blog, I underscored the importance of the number of stem cells harvested during a bone marrow aspirate. Success is dose-dependent. The higher the number of stem cells the better the outcome.

What Is Bone Marrow Aspirate?

A bone marrow aspiration is a  medical procedure that uses a trocar (sharp-tipped instrument, shown at right) to cannulate the bone, commonly in the pelvis. This simply provides a small tunnel into the bone so the liquid portion of the bone marrow (termed an aspirate) can then be removed via a syringe.

Are All Bone Marrow Aspirates the Same?


Most physicians draw a large volume of bone marrow aspirate from a single site. Why? Ease as it takes less time and effort to draw a large volume of bone marrow from a single site. In addition most physicians use a bedside centrifuge and are unable to count the number of cells obtained.

Does It Make a Difference?


Based on the peer-reviewed literature from the ’90s, cannulating many bone marrow sites and aspirating small volumes increases mesenchymal stem cell (MSC) yield over a single site cannulated to withdraw a larger volume.

In the graph below, we compared MSC yield from a single large-volume bone marrow aspirate versus multiple small draws  The small-volume, multiple-site technique, represented by the green bar, provides more cells than a single-draw marrow, represented by the blue bar. For best clinical outcome, you want multiple small aspirations to ensure the highest stem cell number.

On Average How Many Stem Cells Are Aspirate?

The graph below demonstrates the number of patients who have in excess of 800 million cells after multiple-site, low-volume bone marrow aspirate.

On the left are patient ages, and on the top are gender. The critical numbers are highlighted in yellow, which represent the number of patients, both female and male, of various ages who have in excess of 800 million cells. Recall that our data demonstrated that it takes 400 million cells to effectively treat a single knee. If you want both knees treated, as is often the case, you need 800 million cells.

You can see that the percentage of patients who have in excess of 800 million cells is not high and varies between gender and age. Hence, if you want best clinical outcomes, make sure you are getting multiple small-volume aspirates.

At the Centeno-Schultz Clinic, we understand that stem cell yields from bone marrow aspirates matter as they will dictate clinical outcome. We also acknowledge that for maximal stem cell yield, one must draw small volumes from a multiple number of sites. All bone marrow aspirates are performed under X-ray or ultrasound.

If you are considering a bone marrow stem cell procedure, ensure following:

  1. The procedure is performed under guidance.
  2. Bone marrow draw is performed with multiple small-volumes aspirates.
  3.  The number of stem cells aspirated is provided.

This is all the standard of care at the Centeno-Schultz Clinic. Anything less is a waste of your time and hard-earned money.