Stem Cell Success in Ballet Dancer with Ankle Instability

Ankle instability can mean the end of a career or passion.

Micro motion in the ankle can led to additional injuries and accelerate the degenerative process as discussed in Ortho 2.0.

Stem cell treatments are an alternative to ankle surgery.  CK is a case in point.

CK is active equestrian and ballet dancer who sustained a severe ankle sprain who presented to the Centeno-Schultz with a 4 month history of ankle instability and pain. Her  symptoms were progressive in  nature , exclusively located over the lateral aspect of the ankle and refractory to conservative care.  MRI was signficant for complete rupture of the anterior talofibular ligament and Grade 2 sprain of the calcaeofibular ligament.

The importance of the anterior talofibular and calcaneal fibular ligament has been discussed in a prior blog.

CK underwent ultrasound  guided injections of both prolotherapy and  Regenexx PL and SCP with significant improvement.  Initial MRI of ankle noted a complete rupture of ATF whereas followup studies demonstrated  a thick and wavy ATF ligament.  Pre and post MRI images will be posted at a later time.    Most importantly CK avoided a surgery and is back to her passions: dancing and riding.   Congratulations!!

Quadriceps Tendon Pain

The Centeno-Schultz Clinic offers PRP, prolotherapy and bone marrow and platelet derived stem cell therapies.  An understanding to function and stability is essential and is covered in Ortho 2.0.  Direct visualization using MSK ultrasound or x-ray is our standard to ensure accurate placement and to avoid the complications associated with blind knee injections.

Muscle and tendon function is critical to the knee joint health. A brief review of the anterior compartment is helpful.

The quadriceps is a group of large muscles in the front of the thigh.  It consists of four major muscles:

Rectus femoris: A large muscle that covers most of the other, deeper quadriceps muscles.

Vastus lateralis

Vastus intermedius

Vastus medius

A tendon is a fibrous band of connective tissue that connects the muscle to the bone.  The quadriceps tendon attaches the quadriceps muscles to the patella.

Quadriceps control knee extension and stabilize the kneecap (patella).

Pain can arise from the quadriceps tendon due to inflammation, chronic degeneration or tear.  A tear can be either partial or complete and is usually the result of trauma.  Tendon weakness predisposes to tears.  Conditions that can lead to tendon weakness include  quadriceps tendonitis, chronic diseases, steroid use, immobilization and the use of a class of antibiotics called fluoroquinolones.

Orthopedic Stem Cells: How they work

At Centeno-Schultz Clinic we acknowledge the regenerative potential of stems cells in treating common orthopedic injuries.   Dr. Centeno authored a chapter on stem cell use in orthopedic injury.
Regenexx C & Regenexx SD are alternatives to knee surgeries.

How do stem cells work?

Three principal ways:  differentiation, paracrine affect and regulation of inflammation.

Mesenchymal stem cells are multipotent and can differentiate into cartilage, tendon, bone and ligament.

Paracrine means that mesenchymal stem cells release certain growth factors to assist in tissue repair.  Mesenchymal stem cells  can be viewed as construction managers as they recruit other cells to the local area and coordinate the repair of damaged tissue.  The growth factors include TGF-beta, VEGF and FGF.

Finally MSC’s have been demonstrated to regulate inflammation.  Inflammation is not all bad and is the first step in healing.