What is BMA, PRP & Prolo?
Bone Marrow Aspirate (BMA) is made from fluid taken from bone marrow. The bone marrow aspirate contains signaling cells that can help the healing of some bone & joint conditions. Bone marrow aspirate is obtained with a common, standardized minimally invasive procedure that avoids the risks of an invasive surgery. A needle is used to remove marrow from within the bone. This is done under light sedation or local anesthesia. Marrow is commonly taken from the pelvis but may be taken from other sites. Once the marrow is removed it is then injected without modification. The surgeon injects the marrow directly into the surgical site under image guidance. BMA can be used to help with bone healing, cartilage damage, arthritis, tendonitis, labral tears, rotator cuff tears, among other neuromusculoskeletal ailments. Most patients see improvement within 4-8 weeks, with continued improvement for up to 12+ weeks. Similarly Platelet Rich Plasma (PRP) is done with a standard blood draw to collect blood for concentration in a centrifuge and then injected into the areas of damaged tissue. This technique takes advantage of the intrinsic wound repair properties of autologous signaling cells to start a healing cascade when injected into damaged tissue. Prolotherapy (Prolo) also known as proliferative therapy is when a dextrose solution is injected into the injured region to induce a healing response. The mechanism of action is similar to the other regenerative injections by creating a healing response, but does not require a blood/marrow draw.
You are a candidate for this procedure because conservative management for your orthopedic injury/pain has not provided significant relief & are either not a surgical candidate or are only interested in non-surgical options. Your procedure utilizes an FDA cleared device & follows same day procedure FDA orthobiologic guidance (BMA/PRP) of minimal manipulation & homologous use, but still may be considered off label & investigational. This means they are not first line treatments & there is scientific debate about their therapeutic value. See references for safety/efficacy studies. You may inquire further for more detailed & specific information at anytime.
POST Orthobiologic Regenerative (BMA/PRP/Prolo) DISCHARGE INSTRUCTIONS
- Keep site clean/dry for 48 hours, no soaking. Light shower okay 24 hours after your injection.
- Recommended to ice to injection site for ~20 minutes every 2-3 hours the first 48 hours as needed.
- Do not operate heavy machinery or drive for 48 hours, longer if anesthesia effects.
- You may experience a post-injection flare up due to your immune system being hyper-stimulated within
the first 24-72 hours. This potential flare-up can lead to feeling very sore within a few hours of the
procedure. Ice & pain medication as directed will reduce discomfort. These symptoms may potentially last
1-2 weeks. - DO NOT use any medication containing ibuprofen, naproxen, aspirin, dexamethasone or other
prescription ANTI-INFLAMMATORY/STEROID medicines such as Motrin, Advil, Aleve,
Voltaren, Mobic, Daypro, Feldene, Lodine, and Orudis for 2 weeks prior to the procedure, as well as
2 weeks after procedure (preferably 4-6 weeks. If you are not sure if a medication should be taken,
call your PCP or our office. - You may use Tylenol (acetaminophen) up to 1000mg every 8 hours, max 3g/day if no contraindication.
- Contact office & discuss with physician about alternative pain control options.
- Light daily activity is ok, no lifting or prolonged activity. May resume pain-free HEP/PT in 2 weeks.
- Call the physician immediately if you develop drainage from the injection site, redness, swelling,
bleeding, significant stiffness or pain worsening, fever, shortness of breath or other significant medical
change. If office closed, proceed to the emergency room for evaluation. - Patient to follow up in 4 weeks or sooner if needed to assess injection efficacy/effect.
Follow-up appointments/questions:
Manhattan Pain Medicine @ (646)-580-3538
2 Fifth Avenue, Suite 7
New York, NY 10011