BMAC Stem Cell Therapy for Hip Osteonecrosis

Hip osteonecrosis — also called avascular necrosis (AVN) — occurs when blood supply to the femoral head is disrupted, leading to bone cell death and progressive collapse of the hip joint. Once significant collapse has occurred, hip replacement becomes unavoidable. BMAC stem cell therapy, often combined with core decompression, represents the most evidence-supported non-surgical option for early to intermediate-stage osteonecrosis — and the best opportunity to preserve the natural hip joint.

Dr. William Bonner, a credentialed Regenexx network provider in Miami, performs image-guided BMAC procedures for hip osteonecrosis with published Regenexx outcome data for this specific indication.

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Why Early Treatment Is Critical

Osteonecrosis is staged by the ARCO classification:

  • Stage I — MRI findings only; no X-ray changes: best window for non-surgical treatment
  • Stage II — Visible X-ray changes; no collapse: still treatable non-surgically
  • Stage III — Subchondral fracture; early collapse: borderline surgical candidacy
  • Stage IV — Joint space collapse and secondary arthritis: typically requires replacement

BMAC is most effective for Stages I and II. If you have been diagnosed with osteonecrosis, prompt evaluation is essential — the treatment window closes as the disease progresses.

How BMAC Targets the Biology of Osteonecrosis

  • Mesenchymal stem cells — differentiating into osteoblasts and supporting new bone formation in the necrotic zone
  • BMP-2 and VEGF — stimulating bone repair and potentially supporting revascularization
  • Anti-inflammatory cytokines — addressing the biological environment contributing to ongoing bone cell death

BMAC is most commonly performed alongside core decompression — where small channels created through the femoral neck into the necrotic zone allow BMAC to be delivered directly into the affected bone.

Common Causes of Hip Osteonecrosis

  • Corticosteroid use — the most common non-traumatic cause
  • Alcohol use disorder
  • Hip trauma or dislocation
  • Coagulation disorders and hypercoagulable states
  • Sickle cell disease
  • Radiation therapy to the hip region
  • Idiopathic — no identifiable cause

Why a Regenexx Provider Makes a Difference

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.

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What to Expect

Bone marrow is aspirated from the posterior iliac crest under local anesthetic and fluoroscopic guidance, concentrated in-office using Regenexx protocols, then injected into the hip under fluoroscopic guidance with contrast confirmation. Full procedure time including processing is approximately 2.5 to 3.5 hours in a single visit.

Most patients resume light daily activities within 1–3 days. Improvement develops gradually over 6–12 weeks, with continued benefit over 3–6 months.

Frequently Asked Questions

Is BMAC a proven treatment for hip osteonecrosis?

BMAC combined with core decompression has the strongest evidence base of any non-surgical intervention for early-stage hip osteonecrosis, including randomized controlled trial data showing improved outcomes versus core decompression alone. The Regenexx network has published outcome data for this specific indication.

I was just diagnosed with AVN — how urgent is treatment?

Very. Osteonecrosis is progressive and the window for non-surgical intervention closes once significant bone collapse occurs. Prompt evaluation is critical.

Can osteonecrosis occur in joints other than the hip?

Yes — osteonecrosis can affect the knee, shoulder, and ankle. Dr. Bonner evaluates and treats osteonecrosis at these sites using BMAC-based protocols.

Is the bone marrow aspiration painful?

The area is numbed with local anesthetic before aspiration. Most patients experience mild to moderate pressure during the aspiration itself, resolving quickly. Post-procedure soreness at the aspiration site typically clears within a few days.

Schedule a Consultation

If you are dealing with hip osteonecrosis and want to explore whether BMAC therapy is right for you, we are here to help.

Contact our Miami clinic to schedule an appointment with Dr. Bonner, or book online through ZocDoc for available appointment times (if you do not see availability, please reach out to us directly at 786-522-4959).

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