
Bone Marrow Aspirate Concentrate Therapy for Tennis Elbow

What is Tennis Elbow?
Tennis elbow (lateral epicondylitis) is a common cause of chronic pain on the lateral side of the elbow. The main symptoms of this condition can be debilitating, including decreased grip strength, pain, and decreased functional activities. Stem cell therapy is an exciting new treatment for tennis elbow.
How common is tennis elbow?
The condition was discovered years ago when a group of active tennis club players had soreness and loss of mobility of their elbows. The average age for the condition was around 40 years, and the incidence of occurrence was found to be 4.5 per each 1,000 persons.
What causes tennis elbow?
Tennis elbow is often caused by the force of the racket hitting balls when it is held in the backhand position. The forearm muscles attach to the outside of the elbow, and they suffer from excessive strain. Improper backhand stroke, weak wrist or shoulder muscles, and hitting the ball off center will contribute to the condition.

How does stem cell therapy work?
The stem cells are removed from the patient’s own body, by aspirating tissue from the back of the hip bone (iliac crest) or from the fat tissue. These cells are processed in the laboratory in a centrifuge, which separates the stem cells from other body cells and components.
Stem cells are injected into the elbow region, and they stimulate healing of the elbow by producing regeneration of collagen and elastin. In addition, the stem cells transform into healthy elbow tissue.
What are stem cells?
Stem cells are undifferentiated cell types that have the potential to transform into specialized types of other cells. Adult stem cells come from the patient’s own body. The ones that are used to treat musculoskeletal issues are called mesenchymal stem cells (MSCs). These multi-potent cells are used to treat tennis elbow.

How are MSCs obtained?
The human body has many storage sites for stem cells, which can repair degenerated, damaged, and injured structures. Stem cells are obtained from the bone marrow in a simple procedure. The doctor first cleans the skin over the hip with an antiseptic solution, then numbs the skin using an anesthetic. Under x-ray guidance, a special needle is inserted into the hip bone cortex. The liquid marrow is withdrawn using aspiration. After the needle is removed, a small bandage is applied to the site. The stem cells are taken to the laboratory for processing.
How are stem cells injected?
After you have a consultation with the doctor, a nurse goes over the procedure risks and benefits and has you sign a consent form. Using fluoroscopy, the area of injury is identified. After the skin is cleaned and numbed, a fluoroscope is inserted into the site, and the stem cells are injected.

When will I notice improvement?
After treating tennis elbow with a stem cell injection, the benefits are seen in 2-3 months. Immediately after the injection, the elbow will be tender and slightly swollen. This will resolve over the next couple of weeks, however.
How many injections are required to treat lateral epicondylitis?
The number of stem cell injections needed depends on the severity of the condition and the individual patient. Most patients require at least 2 injections, but the doctor may choose to administer a series of 3-4 injections, which are spaced 3-4 months apart.
Resources
- Singh A, Gangwar DS, & Singh S (2014). Bone marrow injection: A novel treatment for tennis elbow. J Nat Sci Biol Med, 5(2), 389-391.
- Nirschi RP (2015). The epidemiology and health care burden of tennis elbow: a population-based study. Ann Transl Med, 3(10), 133.
All content has been reviewed and approved by orthopedic specialist Dr. Zvezdomir “Zed” Zamfirov. Dr. Zed’s practice — All Star Pain Management and Regenerative Medicine — proudly serves the Annapolis, Greater Baltimore and Washington D.C. areas.
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