Stemcelldoc's Weblog

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.

June 9, 2010

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.

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