1700 - Symptomatic and Functional Improvement Following BMAC Injection for Refractory Knee Osteoarthritis: A Retrospective Case Series

Refractory knee osteoarthritis managed with bone marrow aspirate concentrate (BMAC) injections.

Case Description: This retrospective case series examines seven patients with refractory knee osteoarthritis treated in an outpatient setting by an interventional pain physiatrist. Bone marrow aspirate was obtained from the posterior iliac crest under fluoroscopic guidance and injected intra-articularly into the affected knee. Pre- and post-procedure patient-reported outcomes were assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS), with retrospective data collection. Patients also provided subjective reports on pain relief, symptom onset, functional changes, and satisfaction.

Discussions:

Bone marrow aspirate concentrate, an autologous orthobiologic containing mesenchymal stem cells and other cell types, is under investigation for knee osteoarthritis due to proposed anti-inflammatory and regenerative effects. All KOOS subscales improved following injection, with the largest mean gains in Sports/Recreation (+166.7%) and Quality of Life (+184.6%). Six of seven patients reported some degree of pain relief and functional improvement, and five were completely or very satisfied. One patient experienced no improvement. No adverse events or complications occurred.

Conclusions:

In this case series, in-office BMAC injections were associated with notable improvements in pain, function, and quality of life in patients with refractory knee osteoarthritis. Findings align with previous reports supporting BMAC as a joint-preserving alternative for individuals not yet ready for arthroplasty, with outcomes comparable to platelet-rich plasma therapy. BMAC appears safe, well-tolerated, and potentially effective for selected patients.