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Obtaining Bone Marrow: Bone marrow which contains stem cells and other growth factors can be directly obtained from bones such as the tibia (leg) or the iliac crest (hip) by drilling a needle through the cortex of the bone until the bone marrow is reached. We first apply anesthetic cream to the skin over the bone marrow aspiration site. Dr. Hauser injects anesthetic solution down to the periosteum (bone covering) where the bone marrow will be aspirated (similar to novacaine in the dentist’s office.) We allow the anesthetic to produce a numbing effect, generally 10-15 minutes, then the bone marrow is aspirated typically from the tibia (or iliac crest.) This process just takes seconds and is painless. The patient only feels pressure. The bone marrow is then withdrawn into a syringe containing an anti-coagulant.
 View Video Watch Dr. Hauser discuss how bone marrow is obtained from the patient.
Administering Bone Marrow/Stem Cell Prolotherapy: Bone marrow Prolotherapy involves injections, just like any other type of Prolotherapy, except we use bone marrow. These substances are injected into the injured area, just like other Prolotherapy solutions. Once we have obtained the bone marrow, it is then either concentrated then injected (BMAC, bone marrow aspirate concentrate) or just directly injected without concentration (BMA, bone marrow aspiration) into the injured area.
Concentrated Bone Marrow Prolotherapy: When the bone marrow is obtained, it is then mixed with whole blood that has been collected from a venipuncture in the patient’s arm, then filtered, and concentrated in a special centrifuge that spins and extracts the growth factors into a concentrated form. Then the concentrated bone marrow is injected into the injured joint(s). Dr. Hauser also typically injects the structures around the joint to stabilize them using standard Hackett-Hemwall Prolotherapy.
Direct Bone Marrow Prolotherapy: Once the bone marrow is obtained from the tibia or iliac crest, the direct bone marrow Prolotherapy method involves just that – directly injecting the bone marrow into the injured joint(s). Dr. Hauser also typically injects the structures around the joint to stabilize them using standard Hackett-Hemwall Prolotherapy solution.
 View Images View the Direct Bone Marrow Aspiration Injection.
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| Step 1. The patient’s knee is exposed and the skin is marked with an ‘x’ where the bone marrow will be drawn from the tibia bone. |
Step 2. The skin is shaved to help eliminate some risk of infection and so as not to catch any hair in the drilling mechanism. |
Step 3. An anesthetic cream is placed on the area to be treated to numb the surface of the skin. |
Step 4. After approximately 15 to 20 minutes the anesthetic cream is removed. |
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| Step 5. The area is then thoroughly cleaned with an antiseptic solution. |
Step 6. Procaine, or other suitable numbing agent, is injected to anesthetize the site of the bone marrow extraction. |
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| Step 7. Procaine, or other suitable numbing agent, is also injected into the joint. |
Step 8. The drilling mechanism, with Trocar, is used to pierce the tibia bone and allow extraction of the bone marrow. |
Step 9. The middle of the Trocar, or cannula, is removed and a needle remains in which a syringe can be attached. |
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| Step 10. The bone marrow is drawn from the tibia bone. |
Step 11. The syringe is removed, but not the needle, and then the bone marrow is prepared for injection into the injured area. |
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| Step 12. An empty syringe is attached to the needle in order to provide stability and a grabbing point while removing the needle from the tibia. Pressure is then applied to the area. |
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| Step 13. The entire bone marrow aspirate is then injected directly into the injured knee. |
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| Step 14. Following the bone marrow treatment, standard Hackett-Hemwall Prolotherapy is performed around the entire joint to accelerate the growth and repair of the surrounding ligaments and tendons. |
Step 15. The knee is cleaned once again and the treatment is complete. |
Additional injections are typically performed at the injury sites into and around the areas to enhance the healing effect. Most patients also receive Hackett-Hemwall Prolotherapy to help stabilize the joint and stimulate the repair of other structures that are contributing to the joint instability and/or pain for the patient.
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