Human bone marrow (BM) has been highlighted as a promising source of mesenchymal stromal cells (MSCs) containing various growth factors and cytokines that can be potentially utilized in regenerative procedures involving cartilage and bone. However, the proportion of MSCs in the nucleated cell population of BM is only around 0.001% to 0.01% thereby making the harvesting and processing technique crucial for obtaining optimal results upon its use in various regenerative processes. Although several studies in the literature have given encouraging results on the utility of BM aspiration concentrate (BMAC) in various regenerative procedures, there is a lack of consensus concerning the harvesting variables such as choice of anesthetic agent to be used, site of harvest, size of the syringe to be used, anticoagulant of choice, and processing variables such as centrifugation time, and speed. In this review article, we aim to discuss the variables in the harvesting and processing technique of BMAC and their impact on the yield of MSCs in the final concentrate obtained from them.

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A 12 yrs. old boy was brought to our hospital on 11 th January 2017 with the chief complaints of deformity and restricted movements of left elbow since 1 year six months. Patient gives a history of fall on outstretched hand while playing 1 and ½ years back on January 11 th 2017 following trauma patient was taken to local bone setter where bandage was applied after massaging for a total of 3 times over a span of 1 month and after the bandage was removed patient noticed he had restriction of movements and deformity over the left elbow. He did not take any medical advise for the same and now after 1 and half years presented to us with the above mentioned complaints. Patients also gives history of fall previously on 2 nd Feb. 2015 for which he again went to local bone setter and bandage was applied for 14 days and later patient was symptom free until the second trauma. On examination, patient had reduced carrying angle (cubitus varus deformity) of left elbow associated with internal rotation of left forearm. Medial and lateral supracondylar ridges were thickened. The 3 bony point relationship was not altered, elbow range of motion was reduced with flexion only until 90 degrees, there was no limb length discrepancy and distal neurovascular status was intact. Range of movements of ipsilateral shoulder and wrist were within normal limits. AP and LATERAL views of x-ray of left elbow was done. X-ray was reported as malunited supracondylar humerus fracture. After counselling the patient and after obtaining written consent, surgical intervention was done under general anaesthesia. Lateral closed wedge osteotomy procedure was done with additional 2 k-wires was inserted and A/E pop slab was applied and post operatively patient had no complications and sutures were removed on the 10th day.