Autologous Bone Marrow Cell Therapy for the Knee: Are We There Yet?

Abstract

Knee pathology including osteoarthritis and chondral defects continue to account for a large burden of health care visits and significant dysfunction among patients. Injectable biologics have become a focus of greater interest as treatment to mitigate symptoms and potentially restore function or structure. In particular, bone marrow derived treatments, such as aspirated bone marrow aspirate concentrate (commonly referred to as BMAC) have attracted attention as one of the few options that may contain viable autologous stem and progenitor cells that are compliant with Federal Drug Administration regulations. However, recent literature has reported significant shortcomings including variability in the preparation methods, quality reporting, and outcome measures used to assess BMAC efficacy. This manuscript provides a comprehensive review of the most recent recommendations for processing and reporting BMAC in clinical trials with special focus on knee pathology, and presents an evidence-based discussion of the most recent studies reporting on patient outcomes.