Open Ended Trocar vs. Fenestrated Blunt Trocar in Bone Marrow Aspirate for Osteoarthritis

Inclusion Criteria: * Male or female, age 18-79 * Patients have tried at least 6 weeks of conservative therapy including: activity modification, weight loss, brace, NSAIDs, corticosteroid injection * Radiographically confirmed Kellgren-Lawrence I-III OA (no bone-on-bone) * Patients can provide written informed consent Exclusion Criteria: * Clinically and radiologically confirmed anterior/posterior cruciate ligament deficiencies * History of meniscal injury other than degenerative meniscal tears * Presence of a degenerative meniscal tear causing mechanical symptoms such as locking, buckling, or give-way * Major mechanical axis deviation of more than 50% into either compartment (varus or valgus) * Intra-articular injection to affected knee within 3 months of intra-articular BMA injection or HA within 6 months * Body mass index of 35 or more; 18.5 or less (malnourished) * Active infection * Ongoing infectious diseases, including HIV and hepatitis * Clinically significant diabetes, cardiovascular, hepatic, or renal disease * Active malignancy, undergoing treatment, has undergone treatment, or has decline treatment * Use of anti-inflammatory medications, including herbal therapies, within 7 days of BMA * Use of anti-rheumatic medications, including methotrexate and other antimetabolites, within 3 months prior to study entry * History of radiation therapy * History of or current drug or alcohol use disorder * Current cigarette smokers * History of anemia, bleeding disorders, or inflammatory joint disease (rheumatoid arthritis, infectious arthritis, hemophilic arthropathy, Charcot's knee) * History of metabolic bone disease (osteoporosis, osteomalacia, rickets, osteitis fibrosa cystica, Paget's disease of bone) * Pregnant or currently breast-feeding * Participation in a study of an experimental drug within 60 days of study entry