• Avoiding peripheral blood in the aspirate

• Combining Centrifuge and non-centrifuge marrow aspirate: Plasma proteins

• Photobiomodulation 

The following techniques have been shown to minimize peripheral blood and improve the cell count of an aspirate:

• Aspirate a small volume per location, less than 2 mL and preferably 1 mL, within the medullary space.   

• Aspirate as you advance the cannula forward to prevent a void from forming within the bone space.  The cannula fills the space as you advance which prevents peripheral blood from filling the channel.

• Each location you aspirate from should be at least 2cm apart.  

• Realistically, for each puncture you can obtain approximately 3 ml of high cellular aspirate from two separate locations. 

• Use a device that has five side apertures to normalize the pressure between the side holes and end hole.

• Plasma proteins- 

The proteins, exosomes and other proteins within the plasma represent 6% to 8% of the volume of the plasma.  Adding these proteins to a treating composition further concentrates certain growth factors.

Photobiomodulation (PBM) of a marrow aspirate sample ex vivo was associated with a significant increase in the number of BM MSCs colonies compared to the control.  

“PBM of the sample was associated with a six-fold increase in the number of BM MSCs colonies compared to the control. “

“This study demonstrates that fibrinogen is safe and a widely available extracellular matrix that can be used as a versatile scaffold for cells.”

“Ex-vivo Photobiomodulated BMA prepared from centrifuged and non-centrifuged samples that are combined with Exosomes & Plasma Proteins from the plasma substrate of the centrifuged BMA: The Exo Advantage protocols allow you to customize the synergistic effect of different capabilities without incurring additional costs.”