Stemcelldoc's Weblog

April 17, 2014

Anterior and Posterior Cruciate Ligament Injection of Stem Cells Under X-Ray

At the Centeno-Schultz Clinic accuracy is a cornerstone of our practice.  Accordingly we perform all injections under either x-ray or MSK ultrasound guidance.

The Anterior and Posterior Cruciate ligaments (ACL and PCL) are critical stabilizers of the knee.

LL is a 35 y/o athletic male from Indonesia who sustained tears into both the ACL and PCL and rejected traditional surgery.   Today we injected bone marrow derived stem cells into both ligaments with precision utilizing x-ray guidance.  Below is the image demonstrating the injection of contrast into both the ACL and PCL.  a small amount of contrast is injected prior to the stem cells to confirm accurate needle placement.  The PCL is outlined in yellow whereas the ACL is in red.

Anterior and Posterior Cruciate Injection

 

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March 25, 2014

ACL Tear Stem Cell Study: Free Care for Those Who Meet Criteria and can Travel

tree with clouds

The Centeno-Schultz Clinic is a research based medical practice that acknowledges the importance of research.

Our publications to date are multiple and easily identified in the U.S. Library of Medicine.

Stem cell therapy is a successful alternative to traditional surgery in the treatment of ACL tears.

Successful cases of ACL repairs have been discussed in prior blogs with comparisons of pre and post MRI’s illustrating the healing afforded by autologous stem cell treatment.

Regenexx currently has an ACL stem cell study which is available for patients that qualify and can travel to our Broomfield clinic.

Full Inclusion criteria is listed on web site and includes:

  1. Physical examination consistent with lax ACL ligament (Anterior Drawer Test)
  2. Abnormal Telos Arthrometer measurement
  3.  Positive diagnostic MR imaging of the affected knee with at least 1/3 of the ACL ligament at any area along its length having high signal on MRI PDFS/Fat Sat images.

Exclusion criteria is also listed and includes:

  1.  A massive ACL tear or one that includes more than 2/3’rds of the ligament that’s retracted.
  2.  Previous surgery to the affected ACL
  3. Concomitant meniscus tear or cartilage injury that occurred at the same time as the as the ACL tear and which is considered a pain generator.

If you or family or friends are interested please contact us at 303 963-9528 or complete the Regenexx candidacy form.

 

 

 

 

March 17, 2014

Regenexx ACL Procedure Featured in Outside Magazine

outside magazine logo

Regenexx ACL procedure is dynamic new technology that enables a patient to use their own stem cells to heal ACL tears.  This procedure was featured in Outside Magazine.

Extreme skier and founder of DPS Ski, Stephan Drake, tore his ACL while skiing a steep face in Alaska.  He rejected surgical repair and opted for Regenexx ACL at the Centeno-Schultz Clinic in Colorado.

Regenexx ACL is a alternative to traditional knee surgery.  Bone marrow derived stem cells are injected under direct visualization into the ACL.  Patients are fitted with knee brace and undergo 4 weeks of physical therapy.

Complications of ACL surgeries have been discussed previously and include graft failure, infection and acceleration of arthritis.

Successful clinical cases with detailed pre and post treatment MRI’s outlining improvement have been presented in previous blogs.

It is a new day in orthopedic medicine with new opportunities.  Not long ago open heart surgery with bypass and coronary grafting was the standard of practice.  Then interventional cardiology with a new skill set including balloon angioplasty became the new standard of care making coronary bypass surgery a less prevalent and less attractive procedure.

March 2, 2014

Successful Repair of Anterior Cruciate Ligament Tear with Stem Cells

At the Centeno-Schultz Clinic we recognize that tears of the Anterior Cruciate Ligament (ACL) can be game changers.  Surgical repair is associated with significant complications which include infection, graft failure and alteration of biomechanics.  Many patients who undergo surgical repair do not return to high level competition.

Stem cell therapy is a viable alternative to traditional surgical repair.   The Regenecxx  SD procedure enables a patient to forgo surgery, the lengthy rehabilitation and utilize their own stem cells to heal tears in the ACL.

HK is a case in point.  He is a 44 y/o athletic weekend warrior who sustained a hyper-extension injury with near complete tear of the ACL.  He declined surgical repair and underwent Regenexx SD.  6 months post injection of his stem cells he had complete return to normal activities and sports.  His professional and scholastic endeavors delayed follow-up MRI which accounts for the gap in pre and post imaging.

Pre and post stem cell treatments are posted below.  The pre-injection images are on the left and the post injection images are on the right.  The first images are taken from the side (sagittal) whereas the second set are frontal (coronal).

The thigh bone is on top (femur) and the tibia is below.  The ACL stretches across the knee-joint and prevents excessive forward motion.  The ACL is outlined in dashed yellow lines.  On the pre-injection images note the disorganized quality of the ACL fibers and the disruption of the ACL towards the top.  On the post injection images the ACL fibers are well-organized, tight and uniform extending from the tibia to the femur.  The formal MRI report post stem cell injection notes no tear in the ACL which is consistent with HK’s clinical results.

Keel Successful ACL Stem Sag

Keel Successful ACL COR

In 2014 stem cell treatment is an alternative to traditional surgery for tears of the ACL.

January 29, 2014

Pitfalls of ACL surgical reconstruction: Consider Stem Cell Therapy

ACL tear illustration

At the Centeno-Schultz Clinic we understand that injury to the anterior cruciate ligament (ACL) can be a game changer.

Repair of anterior cruciate ligament (ACL) tears with stem cells  is an alternative to traditional surgery.

Regenexx SD utilizes a patient’s own stem cells to repair ACL injuries.  Case reports have demonstrated the successful repair of ACL injuries without surgery utilizing a patient’s own stem cells.

The anterior cruciate ligament is the most commonly injured ligament in the United States with a prevalence of 100, 000-200,000 case per year.  There are in excess of 150,000 ACL reconstructions performed per year.

A surgically repaired ACL is not like the original ACL.

What are the risks associated with surgical repair of ACL tears?

-Infection

Graft failure ranges from 3-27%.

Development of osteoarthritis ranges from 51-78%

-Failure to restore movement back to pre-injury baseline.

Increased cartilage load and higher risk of re-injury

-Significant postoperative physical therapy

Bottom Line:  Know that there are non operative options utilizing your own stem cells to repair ACL injuries.

November 30, 2013

Another ACL Tear Successfully Treated With Stem Cells

The Centeno-Schultz Clinic has previously reported on the successful treatment of ACL tears with stem cell therapy.

Stem cell treatments are an alternative to traditional knee surgery.

S.D. is 38 y/o world-class extreme skier who sustained a complete tear of his ACL and declined surgery.  He underwent 5 prolotherapies in Mexico with minor improvement.

drake stephan

On 7.31.2013 S.D. underwent the Regenexx SD procedure where bone marrow derived cells were injected into the torn ACL.  Due to abnormal neurologic examination and history of intermittent lower back pain also underwent Regenexx PL-Disc where concentrated platelet growth factors were injected around the exiting spinal nerve roots and lumbar discs.

On 9.13.2013 S.D. underwent a booster injection with Regenexx cSCP  injected into the ACL under direct x-ray guidance.

A new MRI was recently performed approximately 4 months post stem cell therapy.

The pre and post treatment images are posted below.  The ACL is outlined in yellow.  Note that the ACL fibers are disorganized and loose in the pre treatment images whereas post treatment the ACL fibers are uniform and tightly organized.  This is consistent with his clinical progress as he reports a reduction in pain and increase in stability.  Muscle weakness remains an issue but is improving with MAT techniques.

Drake. ACL pre and post 2013.sagittal

Drake. ACL pre and post 2013.Coronal

Congratulations to SD who declined surgical repair and opted to utilize his own bone marrow stem cells to repair his torn ACL.  Updates to follow as snow continues to fall and the depth of the powder increases.

October 16, 2013

Regenexx Patient Completes 2013 Kona Ironman

Image your day consisting of a 2.4-mile (3.86 km) swim, a 112-mile (180.25 km) bicycle ride and a marathon 26.2-mile (42.2 km) run.  This is without breaks and all events must be completed in 17 hours.

To participate you must have completed prior Ironman competitions under certain and strict guidelines.

kona ironman

Welcome to the Kona Ironman, which is the world championship of all Ironman.

TG is a patient who presented to Centeno-Schultz Clinic with the aim of successfully completing Kona despite ongoing knee pain.

TG is 54 y/o avid athlete and professional with a 15 month history of right knee pain localized on the medial aspect without radiations and  associated with  limp and intermittent swelling.  Treatment to date included unloader brace, steroid injection, PT, massage, trial of NSAID and two knee arthroscopies with partial resection of the medial meniscus.  MRI was significant for mild scarring of the ACL, tear of the medial meniscus, partially extruded medial meniscus , edema in bone on medial femoral condyle and thinning of cartilage in medial and patella femoral compartment and laxity of MCL.

Physical examination was significant for asymmetric calf girth, quadriceps weakness, decreased sensation in right big toes, laxity of the ACL and MCL( medial collateral ligament) and right knee swelling.

Lumbar spine x-ray demonstrated disc space narrowing and 3 mm anterolisthesis.(slippage)

What! Why the back? Refer to SANS in free Ortho 2.0 text

Treatment included:

x-ray guided prolotherapy of ACL and MCL.

Regenexx cSCP into the lumbar epidural space at L4/5 and L5/S1.  Regenexx PL-Disc

Prolotherapy of the supraspinous,  intraspinous, and iliolumbar ligaments.

Regenexx cSCP injected into ACL, MCL.

One of TG’s largest concerns prior to the competition was his knee and he reports that he ‘had no problems”.

We acknowledge all the time, hard work, commitment and dedication it took to qualify and complete in the Kona 2013 Ironman.  Thank you for allowing Regenexx to assist you in achieving your goal.

CONGRATULATIONS !!

October 6, 2013

Centeno-Schultz Clinic Reviews: Continued Success in Football Player with Torn ACL Treated with Stem Cells

Filed under: Knee, Regenerative — Tags: , — stemcelldoc @ 6:57 am

At the Centeno-Schultz Clinic we acknowledge the significance of an ACL tear as it can lead to knee instability, cartilage and meniscus damage, ligament irritation and alternation in gait.  In short, it can be a game changer.

Stem cell treatment is an alternative to traditional ACL surgical repair.

Previous success stories have been posted on patients who declined surgery and underwent stem cell treatment with Regenexx SD.

BT is 19y/o college football player who tore his ACL and rejected surgery.  In November 2012 he underwent Regenexx SD where bone marrow derived cells were placed into the ACL.  He had three post stem cell injections and a booster injection which contained SCP and PL.  At follow up he had no pain, instability or restrictions.

This week BT scored his first collegiate touchdown!!!!  Congratulations B!

Tow 1st college touchdown

October 2, 2013

Continued Success with ACL Tear Treated with Stem Cells

MM is a 16 y/o athlete who torn her ACL and declined surgical repair.  She opted for Regenexx SD where bone marrow derived stem cells along with platelets are utilized to repair injured tissue.

Regenexx SD has been used successfully in the treatment of ACL tears in other patients.

MM tore her ACL in 2.2013 while playing soccer and underwent stem cell treatment in march 2013.

MRI 3 months post Regenexx SD demonstrated improvement which corresponded with her signficant clinical improvement.

Patient underwent x-ray guided injection of cSCP as a booster in July 2013.

I recently reviewed new knee MRI which is 6 months post stem cell treatment.   It demonstrates continued improvement and healing.  Most importatly there is no ACL tear.  MM is now active and without pain or instability.

Below are the pre, 3 month and 6 month post Regenexx MRI’s.  Note the serial improvement in the ACL fibers which are outlined in yellow.

Slide1

Slide2

Most recent MRI report demonstrates no ACL tear.

MM MRI report 2.

Congratulations to MM and her family who embraced stem cell therapy and avoided surgery.

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.
Congratulations!!

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