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Source: Research by Tim Friend and Dan Vergano, USA TODAY By Frank Pompa and Julie Snider, USA TODAY

Although the general public considers stem cell therapy an innovative, cutting-edge treatment, the fact is that this kind of therapy already has a lengthy history. In the past, however, stem cells were difficult and very expensive to obtain. Luckily, the advent of improved equipment and techniques has meant that stem cells can now be acquired through a simple procedure.

Stem cells can be characterized as the bodys repairmen. The most common type is the hematopoietic stem cell (HSC-CD 34+). The old thinking was that the hematopoietic stem cells were not that important. We now know that these are the cells that are the true drivers of tissue regeneration. The good news about these cells is that their numbers do not diminish with age. The other type of stem cell associated with tissue healing is the mesenchymal stem cell (MSC), which usually travels to injured areas of the body via the bloodstream. The mesenchymal stem cell is still a very important stem cell but not as important as it once was. It prepares the area for the other stem cells to do their work.

If the area in question has an insufficient blood supply, this is termed an area of hypoxia, otherwise known as low oxygen content. Hypoxia areas can include the rotator cuff, the joints, meniscus tissue, and other spots with tendon injuries. Typically, these areas are unable to heal properly without help, as the body does not send enough repair cells to the afflicted areas. The inadequate supply of blood in these areas means that the body fails to sense the injury. Fortunately, we are generally able to treat the area, if the injury isnt severe, with platelet-rich plasma. This works by effectively mimicking a blood supply, allowing the platelets to sense the injury and release growth factors, which then prompt the body to send various stem cells to the area.

Stem cells are gathered by aspirating (removing through suction) bone marrow from the back of a patients pelvis. This bloody substance is removed from the patients pelvis with a tiny needle. Since the patient is given a local anesthetic, only minimal discomfort results from the procedure.

In most cases, 2 oz. (60 cc) of bone marrow aspirate is required. The aspirate includes platelets, mesenchymal stem cells, and other kinds of stem cells used in adult stem cell therapy. After aspiration, the bone marrow is placed inside a special container, which in turn is placed into a machine known as a centrifuge. The centrifuge spins the material at a high rate of speed, and this process separates the platelets and stem cells from the remainder of the blood products. It is this concentration of bone marrowcalled BMAC, or bone marrow aspiration concentratethat is reintroduced to the injured area during stem cell therapy.

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