Biologic augmentation for hip arthroscopy — using your own regenerative cells to support healing.

What is it?

Many patients ask about biologic options to improve healing after surgery. One such option is Bone Marrow Aspirate (BMA). BMA harnesses the healing elements normally found in your bone marrow—including growth factors and regenerative stem cells—and delivers them directly to the surgical site. Bone marrow resides within the spongy part of your bones and contains one of the highest concentrations of stem cells in the body.

We use the Marrow Cellution™ system by Cervos Medical, an advanced bone marrow aspiration device that does not require centrifugation. Its patented design minimizes blood dilution at the source, delivering a high concentration of stem cells and growth factors directly from the aspirate. This dramatically reduces processing time and maintains sterility throughout the procedure.

Why bone marrow?

  • Contains the highest natural concentration of stem cells in the body
  • Provides growth factors and cytokines that drive tissue healing
  • Transitions the local environment from inflammation to regeneration
  • Amplifies your body’s own cellular inventory for healing
  • Think of this as a higher level form of PRP

How is BMA used in Dr. Wolff’s practice?

Dr. Wolff offers BMA as a stand-alone injection or as a biologic augmentation to labral reconstruction.

As a stand-alone procedure: For certain patients with hip pain from labral tears, mild to moderate osteoarthritis, or chronic tendon tears, BMA can be performed as an independent injection into and around the hip joint. The BMA is harvested from the iliac crest (pelvis) through a poke hole after numbing the skin. We typically will do this under light sedation if this is done as a stand-alone procedure.

During hip arthroscopy/labral reconstruction: When we do this during surgery, the BMA is instilled directly into the fascia lata allograft tissue during graft preparation, so that the graft—which is donor tissue that essentially serves as a scaffold for your own body to incorporate over time—is enriched with your very own stem cells. Any remaining aspirate is injected into the joint at the end of the procedure. The goal is to enhance the biologic environment in which the graft and hip heal.

What is the evidence?

While research on BMA in hip arthroscopy is still evolving, the existing literature is encouraging:

  • A study published in the Journal of Bone and Joint Surgery showed that patients who received BMA during labral repair demonstrated improved functional outcomes at 5 years, particularly those with concomitant cartilage damage.
  • Patients with labral tears and early degenerative changes who received intra-articular BMA at the time of hip arthroscopy achieved outcomes similar to patients without arthritis, suggesting BMA may help offset the negative effects of early cartilage damage.
  • A systematic review found that BMA may be particularly effective for patients with moderate cartilage damage at the time of labral surgery.
  • BMA harvested from the iliac crest during hip arthroscopy has been demonstrated as a safe and effective technique for treating chondrolabral pathology in the setting of femoroacetabular impingement.
  • BMA combined with a scaffold for cartilage lesions in FAI patients showed superior outcomes compared to microfracture alone at a mean follow-up period.

What is the process?

BMA harvesting is performed after numbing the area while you are lightly sedated or, if being done at the time of surgery, under anesthesia.

A specialized aspiration needle (Marrow Cellution™) is inserted through a poke hole into the spongy part of the iliac crest (your pelvis).

The aspirate is drawn into a sterile syringe and is immediately ready for use—no centrifuge or additional processing is needed. For labral reconstruction cases, the aspirate is rolled directly into the fascia lata allograft during graft preparation. Any remaining aspirate is injected into the hip joint at the end of the case.

There is no additional risk or recovery time associated with the BMA harvest. The harvest site (iliac crest) may have mild soreness for a few days, similar to a blood draw.

The entire process takes 5-10 minutes.

What is the cost?

Currently, BMA is not covered by insurance and is an out-of-pocket expense. Please message us if you are interested.

While the early evidence for BMA in hip arthroscopy is encouraging, long-term data specific to labral reconstruction with BMA augmentation is still limited. We believe in being transparent with our patients. BMA is an evolving area of orthobiologics that shows promise, and we are committed to staying at the forefront of techniques that may benefit your recovery. Please ask Dr. Wolff any questions you may have.

Call our office at 202-838-8837 if you’re interested in adding BMA to your hip arthroscopy or labral reconstruction, or would like more information.

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