BMAC procedure
ASPIRATION, CORTEX
Patients were placed supine under sedation, the surgical field was prepared in a standard fashion with betadine and chlorhexidine. All procedures were performed by two fully trained surgeons (DN and AZ) using the Marrow Cellution™ Bone Marrow Aspiration System (Fig. Marrow Cellution™ Bone Marrow Aspiration SystemThe harvesting area is the proximal tibial metaphysis. After performing a small skin incision, a heparin coated needle 13G was introduced just past the cortex into medullary space. The sharp stylet was removed. Then a blunt stylet was inserted, and the access needle was advanced to desired depth, rotating a guide grip to skin level (Fig. The blunt styletThe blunt stylet was removed, and an aspiration cannula connected to a 10 ml syringe. 10 ml of BMAC was aspirated holding a guide grip and rotating the handle 360° counterclockwise gradually to allow the fenestrated stylet to be raised to a new level of undisturbed marrow (Fig. BMAC aspirationThe harvest at this point is ready for injection (10 ml) intra-articularly (Fig. Superolateral injectionAfter the injection, the knee is flexed and extended to diffuse the product in the joint. At discharge, patients are partial weight bearing with crutches, and full unaided weight bearing on the treated knee is allowed after 1 week. All patients were instructed to perform isometric quadriceps exercises, and started physiotherapy after 1 week.