Stem cell therapy is a phrase that has attracted significant excitement — and, frankly, significant confusion. Patients searching for alternatives to joint replacement often encounter it and aren’t sure what to make of it. This article focuses specifically on BMAC — Bone Marrow Aspirate Concentrate — which is the form of orthobiologic stem cell therapy that Dr. Scheinberg uses at his Santa Barbara clinic. It’s a distinctly different treatment from PRP, appropriate for different conditions, and it matters a great deal how and by whom it is administered.
What BMAC Is
BMAC is derived from your own bone marrow — the spongy tissue inside certain bones, particularly the pelvis, that is responsible for producing blood cells. Bone marrow is also rich in mesenchymal stem cells (MSCs), which are regenerative cells capable of differentiating into various tissue types, including cartilage, bone, and connective tissue. It also contains a concentrated array of growth factors and anti-inflammatory signaling molecules.
The process begins with a bone marrow aspiration — a minimally invasive procedure in which a small amount of marrow is withdrawn from the posterior iliac crest (the back of the pelvis) using a specialized needle. The aspirate is then placed in a centrifuge to concentrate the therapeutic components. The resulting BMAC is then injected into the affected joint or tissue.
The entire procedure is performed in-office at Dr. Scheinberg’s Santa Barbara clinic, with the harvesting done under the same standards of precision that govern surgical procedures. This is an important distinction. Bone marrow harvesting requires anatomical knowledge and technique that a surgeon is uniquely qualified to bring.
How BMAC Differs from PRP
Both PRP and BMAC are orthobiologic therapies derived from a patient’s own body. The key difference is in what they contain and what they’re designed to do.
PRP is concentrated platelets, rich in growth factors. It excels at accelerating healing of soft tissue — tendons, ligaments, and early joint degeneration. Think of it as a targeted healing signal.
BMAC contains not just growth factors but also mesenchymal stem cells — cells that carry actual regenerative and tissue-modulating potential. BMAC also has a more potent anti-inflammatory effect. For joints with more significant degeneration, or for complex injuries involving labral tissue, articular cartilage, or deep structural damage, BMAC offers a more robust biological environment for repair.
In cases of moderate-to-severe arthritis, Dr. Scheinberg often recommends a combined approach — using both BMAC and PRP together to maximize the regenerative environment in the joint.
What Conditions BMAC Is Used For
At the Scheinberg Clinic, BMAC is typically reserved for cases with greater complexity or more advanced degeneration than PRP alone would address:
Advanced knee arthritis. Clinical research, including a four-year follow-up study published in *Scientific Reports*, has shown that BMAC injections can produce significant improvements in pain and function even in patients with Kellgren-Lawrence Grade III and IV osteoarthritis — the severe end of the spectrum. In that study, no knee replacements were required during the follow-up period.
Hip arthritis and labral tears. The hip joint is notoriously difficult to access accurately. A surgeon’s training in hip anatomy makes a significant difference in outcome.
Shoulder labral tears. For patients with structural damage in the shoulder who are not surgical candidates or who want to exhaust biologic options first, BMAC offers meaningful potential.
Rotator cuff pathology. In more complex rotator cuff cases — particularly where PRP alone has not been sufficient — the addition of BMAC provides additional regenerative support.
Complex joint degeneration in active seniors. For patients in their 60s, 70s, and beyond who want to remain active and avoid or defer joint replacement, BMAC represents a meaningful option that deserves serious consideration.
Why a Surgeon’s Precision Matters
BMAC therapy is not a simple procedure. The harvesting itself requires needle placement in the iliac crest with anatomical accuracy to obtain a high-quality aspirate. The injection into the joint requires knowledge of the precise intra-articular structures that need to be reached.
Dr. Scheinberg performs every step with the same judgment he brings to the operating room. His 40-year surgical career means he has an intimate understanding of joint anatomy that most PRP providers — who may come from internal medicine, pain management, or general practice backgrounds — simply do not have. That difference in skill and knowledge translates directly into procedural precision, and procedural precision translates into better outcomes.
The Santa Barbara Stem Cell Clinic, which Dr. Scheinberg founded, has offered BMAC therapy as part of its orthobiologic protocols since 2016. Patients travel from throughout Central California, Montecito, Bakersfield, and beyond for access to this level of specialized care.