Stemcelldoc's Weblog

January 27, 2010

Achilles Tendon Pain Unresponsive to Therapy

EC is a 80 y/o patient referred for platlelet rich plasma (PRP) injections of his inflamed left Achilles tendon.  Patient was active with no significant past medical history.  He denied any traumatic injury but had a 6 month history of severe left Achilles pain which was constant in duration, 6/10 in severity and progressive.  Treatment to date included physical therapy, trial of non-steroidal anti-inflammatory mediations and massage.   PRP therapy was considedered due to patient’s failure to improve.

PRP therapy is the injection of a patients own platelets into the damaged/irritated tissue.  RPR therapy is aimed at accelerating the healing process. 

Physical examination was significant for the following:  reduced  flexion/extension of lumbar spine secondary to pain,   decreased sensation along the left big toe and outside aspect of foot, decreased strength of left big toe and significant muscle banding in both the back and leg.

 After the initial evaluation, an x-ray of the lumbar spine was obtained which was significant for instability of the several vertebral bodies(anterolisthesis) along with marked reduction in the disc height at L5/S1.

EC’s Achilles tendon problem was not responding to conventional therapy since no have bothered to look beyond the tendon itself.  He had irritation of the left L5 and S1 nerve root which required treatment in addition addressing the Achilles tendon inflammation.

Looking at the bigger picture is essential for maximal clinical outcomes.  This is the essential paradigm required as we move from joint replacement to joint restoration. Ortho 2.0 presents  four principal elements previously discussed.

This is the standard at Regenerative Sciences and  The Centeno-Schultz Clinic.

Ed underwent PRP therapy in addition to injection of platelet derived growth factors at the L5/S1 and S1 levels.  He had  reduction of his debilitating Achilles pain  and headed off to florida for the back nine. I will report back upon his return.

January 26, 2010

New Perspective: Ortho 2.0

Everyone told Christopher Columbus that the world was flat.   

 Friends told the Wright brothers that birds were the only creatures capable of flight.  


A paradigm shift was required.  This also applies to medicine. The time has come to focus not on joint replacement but on joint restoration and repair.     Dr. Centeno has termed this Ortho 2.o.   Ortho 2.0 has a bigger focus beyond just fixing one part of the musculoskeletal system (bone, joints, muscles, tendon, and ligaments).   When the focus shifts to repair, the amount one needs to know about the joint increases exponentially.  There are four principal elements which are addressed when evaluating a gvien joint: (S.A.N.A.)   

ORTHO 2.0 : S.A.N.A.

  S: stabilization   

A: articulation   

 N: neurologic   

 A: alignment   

 Injection of magic stem cells alone is not sufficient for joint restoration.  Multiple studies have shown that just injecting stem cells into a joint blindly is not that effective.  For the best clinical outcomes, each of the factors listed above must be evaluated and treated. At Regenerative Sciences and The Centeno-Schultz Clinic this is the standard.  Case examples utilizing the S.A.N.A. paradigm will be in future blogs.   

It is truly a new day:)    

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