Bone marrow lesions (BMLs) — visible on MRI as areas of abnormal signal within the subchondral bone — are the single strongest MRI predictor of pain intensity in knee osteoarthritis, strongly predict cartilage loss over time, and rarely resolve with rest, physical therapy, or standard injections. Bone marrow aspirate concentrate (BMAC) is uniquely suited to treating BMLs because it is derived from bone marrow itself — making it biologically native to the tissue where the lesion occurs.
Dr. William Bonner, a credentialed Regenexx network provider in Miami, performs intraosseous and intraarticular BMAC protocols for bone marrow lesions — technically demanding procedures requiring specialized training and precise fluoroscopic guidance.
BMLs represent areas of trabecular bone damage, microfracture, edema, and cellular stress within the subchondral bone — the dense bone layer just beneath the articular cartilage. They are not simply bone bruises; in the context of arthritis and chronic mechanical overload they reflect ongoing breakdown at the osteochondral interface.
Intraosseous BMAC — injecting directly into the lesion under fluoroscopic guidance — requires specialized training. Dr. Bonner has this expertise through the Regenexx network, which has developed and refined intraosseous protocols over more than a decade.
Many clinics in Miami advertise ‘stem cell therapy’ using amniotic or umbilical cord products that independent research has shown to contain no viable living stem cells. As a credentialed Regenexx network provider, Dr. Bonner uses your own living bone marrow stem cells — harvested and processed the same day — under strict evidence-based protocols backed by the largest regenerative orthopedics outcome registry in the world. Regenexx is the only organization with this combination of proprietary lab processing, published clinical research, and rigorous provider credentialing.
BMLs are visible on MRI — they appear as areas of bright signal on fluid-sensitive sequences. If your MRI report mentions ‘bone marrow edema,’ ‘subchondral signal change,’ or ‘bone marrow lesion,’ that is what we are referring to. Dr. Bonner will review your imaging at consultation.
Some BMLs from acute trauma can resolve with rest. BMLs associated with osteoarthritis and chronic mechanical overload tend to persist and worsen without targeted treatment.
A standard injection delivers medication into the joint space. Intraosseous BMAC uses a specialized needle advanced through the bone cortex into the subchondral lesion itself — delivering stem cells directly to the bone pathology under fluoroscopic guidance.
Yes — and this is often how Dr. Bonner approaches treatment, addressing both the subchondral bone pathology and the overlying joint environment in the same visit.
If you are dealing with bone marrow lesions or persistent joint pain and want to explore whether BMAC stem cell therapy is right for you, contact our Miami clinic to schedule a consultation with Dr. Bonner, or book online through ZocDoc (click below). If you do not see availability online, please call us directly at 786-522-4959.
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