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.

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

Anterior Cruciate Ligament Injuries and Stem Cell Therapy

Ligaments are  dense  fibrous connective tissue which connect bone to bone.  They provide stability to a given joint. The knee has four principal ligaments.  The anterior cruciate ligament stabilizes the knee and prevents forward motion of the tibia (shin bone) in relation to the femur (thigh bone).  The ACL originates from the femur (thigh bone) and is attached to the tibia .

  The ACL is the most commonly injured knee ligament and is very common  in athletes.  Injury occurs during sudden dislocation, torsion or hypter-extension of the knee.  Diagnosis can be made clinically with either the anterior drawer test or Lachman test.  The diagnosis is typically confirmed by MRI.

Surgical options include repair of the damaged ligament vs complete reconstruction with a patient’s own tendon.  Complications from surgery include infection, blood clots, technical failure, damage to muscles, tendons and associated ligaments and the risk of anesthesia.

Mesenchymal stem cells have the ability to regenerate damaged ligaments.  At Centeno-Schultz Clinic using the Regenexx procedure we are utilizing regenerative therapies to treat ACL injuries.  These treatments include the injection of prolotherapy as well as autologous culture expanded mesenchymal stem cells directly into the ACL.  Below is a recent injection of stem cells into the ACL.  30 days post injection patient reports improved stability and decreased pain.

Normal MRI: No therapy Indicated

 NG is a 34 y/o patient who presented with a 5 year history of left knee pain which was constant in duration, 3/10 in severity, progressive in nature localized principally at the knee cap and deep within the joint.  Her large German Shepard ran into her  left knee 5 year earlier which resulted in onset of severe pain.  Treatment included physical therapy, E-stimulation, steroid injections and one surgery( lateral release).  Surgery unfortunately increased her pain and frustration.  Postoperative MRI of the left knee was normal .   NG was informed that no more therapy was indicated.     

Physical examination was significant for tenderness along the patellar tendon, slight limp, muscle tightness in her lumbar spine and tenderness and pain with palpation of her sacro-illace jont.  Most significant however was the instability of her knee which her husband noted from across the room. The anterior cruciate ligamant(ACL),was very loose suggestive of a tear.  Review of the MRI demonstrated a chronic tear in the ACL.     

The anterior cruciate ligament is one of four major ligaments in the knee.  It originates from the back portion of the thigh bone( femur) and attaches to the front portion of the shin bone ( tibia). It prevents forward movement of the tibia in relation to the femur.  It provides critical stability to the  knee.  Tears of injury to the ACL result in instability of the joint with resultant pain.     

   

 

  

ACL: Thick Black Band

           

 

There is no substitute for a complete physical examination.  MRI’s alone can not make a diagnosis.  Putting the physical findings together with MRI results is the standard of care at The Centeno-Schultz Clinic.       

Utilizing a patient’s own stem cells, repair of a partial tear of the ACL is possible.  The Regenexx procedure affords patients the opportunity to use their own mesenchymal stem cells to treat common orthopedic conditions.