Stemcelldoc's Weblog

March 22, 2011

Stem Cell Therapy for Meniscus Injuries: A Comprehensive Approach

Steep and deep skiing is fantastic but can result in debilitating injuries.

CP is a 60y/o avid extreme snow and water skier who sustained a right knee injury in the back-country.  He had undergone three previous knee surgeries with limited success.

Conservative treatment included active release PT, chiropractic care, acupuncture and trial of NSAID’s without significant benefit.

CP was familiar with the studies which demonstrated progression of degenerative changes after meniscectomies and therefore declined.  He opted to use his own stem cells via the Regenexx procedure.

At the Centeno-Schultz Clinic CP  was noted to have a 15 year history of low back pain, instability of ACL and extreme pain on the medial aspect of the knee.  Physical examination was signficant for laxity of ACL and decreased strength and sensation in his left foot.  X-ray of lumbar spine demonstrated significant lumbar degenerative disc disease most advanced at the L5/S1 level.

Joint stability and maximizing neural function is critical as discussed in Ortho 2.0.

MSK ultrasound allows for a dynamic, real-time examination which in CP demonstrated multiple tears in medial meniscus, partial extrusion of medial meniscus and thickening of MCL.

At the Centeno-Schultz Clinic CP underwent x-ray guided injections of Regenexx PL, prolotherapy of ACL and MCl and Regenexx SD into his medial meniscus via ultrasound guidance.

3 weeks post injection I received this e-mail:

“Overall the joint feels much more stable than before. I am now able to walk down stairs in a normal fashion instead of 1 step at a time. Epidural injections have really diminished lumbar and scapular pain. Down to a bearable 2-3  where before it was 5-7 all of the time. Very noticeable improvement when I bike ride. I felt things tighten up (unprovoked ) in the lumbar region, the the scaps a couple of days ago, still tight but not super painful. Right leg seems to function normally on the mtn bike. I’ve been doing the Sprint 8 routine every 3rd day on reasonably flat trail. Hitting 22mph on the sprints, heart rate of 165, peaking to 170 as come off the sprint for 90 sec recovery which leads me to believe I’m hitting a solid anaerobic level and creating an 02 debt. Still an imbalance from left to right in pedal power. Walking has gotten much easier with the resolution of both the back and knee pain.”

In 2012 CP expects to exceed his previous seasons which is shared with us (he’s the one with the moustache): View CP’s Video

September 21, 2010

ACL Repair with Stem Cells

 

EK is a 31 y/o athletic officer at one of the nation’s military academies who sustained a tear in his ACL.  He opted for a non-surgical therapy.  EK underwent post stem cell therapy  MRI of the knee which is presented below.  There is significant improvement clinically which corresponds with the improvement seen on MRI.  In the pre-injection MRI, the ACL is loosely organized and loose whereas after stem cell therapy utilizing the Regenexx procedure, the ACL is tightly organized and the fibers have a denser appearance.  The ACL is identified with dashed red line.

Here are EK’s comments post injection:

“Yes, my knee feels stronger and more stable in day to day, hiking, running, biking and swimming activities.  I went hiking last weekend with a light overnight backpack on a steep trail.  In loose rock and during slight mis-steps, my knee remained stable.  I did do some activity tests at the  clinic and the chiropracter noted less sharpness on certain resistance motions with my right leg as compared to my left leg. Considering, I heard a pop and couldn’t walk normally for over two months, I’m happy with the improvements my knee has shown.  Stability has improved and mentally I am willing to trust it’s strength.  My PT agreed there was no longer any reason for me to pursue surgery any more. ”

  At the Centeno-Schultz Clinic different regenerative therapies are available which allow patients non surgical options for common orthopedic injuries.   Therapies include prolotherapy, PRP, platelet derived growth factors and expanded mesenchymal stem cells.

July 8, 2010

Anterior Cruciate Ligament Repair Without Surgery

 

The Anterior Cruciate Ligament (ACL) is critical to the support and function of the knee.

A tear in the ACL is a serious injury which can mean the end of an athletic or demanding career.    Surgical options include repair of the damaged ligament vs complete reconstruction with a patient’s own tendon.  Complications  include infection, blood clots, technical failure, damage to muscles, tendons and associated ligaments and the change in the biomechanics of the knee.

EK is a 31 y/o athletic officer at one of the nation’s military academies who sustained a tear in his ACL.  He opted for a non-surgical therapy.  Below is EK’s MRI prior to and 1 month following x-ray guided injection of prolotherapy.  The patient reported improved stability and reduction in pain.  This corresponds with the changes noted on MRI.

The ACL is identified by the red  ovals.  On the left the ACL fibers  are loose and poorly organized; they meander upwards rather than appearing tightly stretched.   In the post-prolotherapy MRI on  the right,  the ACL fibers are tightly arranged moving from the bottom left to the upper right.  The fibers now appear to have a denser appearance (darker in this image).

Patient is scheduled to have re-implantation of expanded mesenchymal stem cells directly into the ACL next week utilizing the Regenexx procedure.  At the Centeno-Schultz Clinic different regenerative therapies are available which allow patients non surgical options for common orthopedic injuries.   Therapies include prolotherapy, PRP, platelet derived growth factors and expanded mesenchymal stem cells.

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