Stemcelldoc's Weblog

September 15, 2013

Anterior Crucuiate Ligament Stability: Tests

At the Centeno-Schultz Clinic stability of a joint is critical.  It is one of the four cornerstone’s in our evaluation.







Laxity of the ACL of the knee is commonly associated with complaints of instability while walking on uneven surfaces and descending hills.

On physical examination there are two principal tests to determine ACL laxity.

lachman test

Lachman Test:  with the knee flexed at 30 degreees the examiner pulls on the tibia to assess the amount of anterior motion of the tibia in comparison to the femur.

Anterior drawer sign:

MRI, CT and x-rays of the knee do not identify laxity as this is a finding on dynamic testing of the joint.

Instability of the ACL predisposes to meniscus, cartilage and ligament injury , damage and pain.

There is an association between ACL integrity and osteoarthritis.

Keegan that looked at MRI’s on about 300 patient with known knee arthritis and found that 1 in 6 had ACL ligament abnormalities.

Stein in another study demonstrated that about 14% of knee OA patients had ACL abnormalities on MRI.

Treatment options include prolotherapy, platelet lysate and bone marrow derived stem cells.

The problems associated with surgical repairs have been previously discussed.

ACL tears have been successfully treated without surgery utilizing Regenexx SD, a bone marrow derived same day stem cell treatment.

If you have had an injury and your knee feels unstable understand that non surgical treatment options and evaluation is available to at Centeno-Schultz Clinic.

Specialized doctor discusses tests to determine ACL laxity and non surgical treatment options.

September 8, 2013

Motor Vehicle Accident and Onset of Symptoms

motor vehicle injury

At the Centeno-Schultz Clinic we acknowledge the potential impact of a motor vehicle accident(MVA).  If conservative therapy fails to provide signficant and sustained  pain relief we have a variety of treatment options.

A MVA can be unsettling resulting in confusion, lack of focus, pain and restriction in range in motion.

Does onset of symptoms have significance?

Richter studied this issues in his analysis of 1176 whiplash-type neck injuries.

Richter demonstrated that complaints starting within the first 24 hours revealed no significance in regard to the duration of symptoms.

Complaints that began after more than 24 hours however lasted twice as long as the rest.

Be safe.  Focus on the road and if you are involved in an accident acknowledge that your symptoms may develop after the initial injury and that there are advanced therapies available.  You do not have to live in pain.

September 6, 2013

Successful Stem Cell Treatment for ACL Tear

At the Centeno-Schultz Clinic we acknowledge that injury to Anterior Cruciate Ligament (ACL) can lead to knee instability, pain, meniscal injury, cartilage damage and restriction in range of motion. Surgical repair is often recommended.

Surgery is not the only option and the problems associated with ACL grafts have been previously discussed.

JP is an active physician who injured his ACL while skiing. MRI of knee was signficant for mid substance disruption of the ACL with signficant swelling and irregularity of the ACL fibers. He had signficant knee pain with restriction in range of motion and used crutches in clinic intermittently.

JP rejected the recommended ACL surgery and opted for stem cell therapy in June 2013. Three months post Regenexx therapy he reports 90% improvement with no restriction in range in motion. MRI post stem cell injection is significant for intact fibers in both the originating and inserting margins with marked improvement in mid substance swelling.

Below are the pre and post MRI’s. The images were taken at the same imaging center. The images on the left are frontal whereas on the right are from the side. The dashed yellow lines outline the ACL. Pre-stem cell injection the ACL fibers are irregular and poorly defined whereas post stem cell injection the ACL fibers are well-organized, tight and well-defined.

ACL Anatomy

Peragine pre and post ACL 1

Peragine pre and post ACL 2

Through stem cell therapy JP is was able to avoid surgery and the lengthy rehabilitation. Yesterday he purchased his season ski pass.

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