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MFAT vs. Bone Marrow Concentrate: What's the Difference?
Quick answer: This post compares MFAT and Bone Marrow Concentrate head-to-head — how each works, where the evidence is stronger, and how we choose for patients in Raleigh & Cary. If you've been researching stem cell therapy for arthritis, you've probably noticed something confusing: different clinics use completely different source tissue.
If you've been researching stem cell therapy for arthritis, you've probably noticed something confusing: different clinics use completely different source tissue. Some harvest fat. Others draw bone marrow. Both get marketed as "stem cell therapy," both are your own tissue, and patients reasonably ask: which one is better?
The honest answer is more nuanced than most clinic websites suggest. Here's how the two actually compare.
First, what both treatments share
MFAT (microfragmented adipose tissue) and bone marrow concentrate (BMAC or BMC) are both autologous — made from your own body, harvested and injected the same day. Both contain mesenchymal signaling cells, growth factors, and other components involved in tissue repair signaling. Both are injected under image guidance into the joint or tissue being treated. And neither has been proven to regrow cartilage — the realistic goal for both is reduced pain and improved function.
The differences are in where the tissue comes from, what's in the final product, and the depth of research behind each.
The harvest: what treatment day looks like
MFAT: A small amount of fat is collected from the flank or abdomen through a tiny poke-hole incision, under local anesthetic. Most patients describe the harvest as pressure and mild soreness for a few days afterward.
Bone marrow concentrate: Marrow is drawn from the back of the pelvis with a needle, also under local anesthetic. The draw itself is brief, but many patients find the deep pressure of a marrow aspiration the most uncomfortable part of either procedure.
Both visits take roughly one to two hours, and you walk out the same day.
What's actually in the syringe
This is where the two diverge most:
Cell concentration: Fat tissue contains a substantially higher concentration of mesenchymal signaling cells per volume harvested than bone marrow does. Bone marrow's cell fraction is small and declines further with age — one reason some researchers favor adipose tissue in older patients.
The surrounding matrix: MFAT retains fragments of the fat's natural tissue scaffold, which may help the cells stay where they're injected and keep signaling longer. Bone marrow concentrate is a liquid product without that structural component.
Other components: Both carry growth factors and anti-inflammatory signaling molecules. Bone marrow concentrate also includes platelets and other blood components similar to PRP.
Neither product is a vial of pure stem cells — despite what some advertising implies. Both are concentrated tissue preparations in which signaling cells are one ingredient among several.
What the evidence says
Bone marrow concentrate has the longer history in orthopedics, with published studies going back more than a decade, including work on knee arthritis and bone healing. MFAT's evidence base is newer but growing, and includes randomized trial data in knee osteoarthritis showing pain and function improvement — with the strongest durability data extending to about one year in controlled trials and longer follow-up in observational series.
What does not exist yet: a definitive head-to-head randomized trial proving one superior to the other for joint arthritis. Anyone who tells you the debate is settled — in either direction — is getting ahead of the data. Reasonable physicians can land in different places; at our practice, we use MFAT, for the cell-yield and harvest-tolerability reasons above, and because its evidence in knee arthritis is now reasonably solid.
Cost and availability
Both are typically self-pay, and pricing is broadly similar — several thousand dollars, reflecting the harvest and processing involved. A practical difference: some national networks use bone marrow exclusively, so if you're comparing clinics, the first question to ask is simply which tissue they use, and why. The answer tells you a lot about the clinic.
How we help patients choose
For most patients with joint arthritis, the choice between MFAT and BMAC matters less than the questions around it:
Is your arthritis actually at a stage where cell therapy makes sense?
Has the diagnosis been confirmed with proper imaging and exam?
Is the injection performed with ultrasound or fluoroscopic guidance?
Is the clinic honest about what the evidence does and doesn't show?
If those answers are good, either product is a defensible choice. If they're not, the tissue source won't rescue the plan.
The bottom line
MFAT and bone marrow concentrate are cousins, not competitors in a settled race. MFAT offers higher signaling-cell concentration and a gentler harvest; bone marrow has the longer track record. Neither regrows cartilage, and neither has beaten the other in a definitive trial. What matters most is candidacy, technique, and honest expectations — the things your evaluation should focus on.
If you're comparing options for arthritis in Raleigh or Cary, come in and we'll walk through your imaging and which approach — including the option of neither — fits your situation.
Call 919.719.2270 to schedule an evaluation at our Raleigh or Cary office.
About Your Physicians
Dr. Matthew Kanaan
Nonsurgical Orthopedic Specialist
Founder of Carolina Nonsurgical Orthopedics. Fellowship trained in sports medicine at Duke; residency in family medicine at Duke, where he served as Chief Resident.
Dr. Pierce Knox
Nonsurgical Orthopedic Specialist
Fellowship trained in nonsurgical sports medicine at Penn Medicine; residency in primary care at Christiana Care.
