Are there ankle fusion alternatives that only involve injections without surgery?
CB is a 39 year old woman who was in a motor vehicle crash several years ago and was told she needed an ankle fusion. She then searched the internet seeking ankle fusion alternatives and found our clinic. In her car crash, she sustained a compound fracture of the right tib-fib that required immediate surgery. She then had a second surgery 6 days later with the placement of an external fixator and then finally a third surgery where internal hardware was placed. She had significant pain for three years and developed difficulty with prolonged walking or standing, including a limp in the winter months. Based on her MRI results we weren’t encouraged. There was severe loss of cartilage and loss of joint space in the large ankle joint (tibio-talar) as well as scarring of one of the ankle ligaments. On exam, as is common in trauma patients, nobody had ever really addressed the moderate amounts of ankle instability due to stretched ligaments. As a result of all of this, we placed her in the POOR category for a same day stem cell procedure. Despite the low odds of success, she had few other options and was unwilling to pursue an ankle fusion surgery, so she wanted to try using her own stem cells. Dr. Hanson and Schultz performed a same day stem cell injection series, carefully placing her cells under fluoroscopic and ultrasound guidance into the main ankle joint as well as key ligaments that were lax on exam. While all not all Regenexx-SD patients can expect the same result, her 9 month follow-up report is below:
“Hi Dr. Hanson! I just wanted to f/u with up on my status since I had my Regenexx procedure in Aug. I just can’t believe how great I’m doing. I have had such a decrease of pain that at times I forget I even had severe ankle pain for three years following the car accident. I now can walk all day when I go to theme/amusement parks and hiking. Yesterday, I went to … and walked all day and felt great!! WOW!!! I thought about you on my drive home and I want to tell you how thankful I am. I hope you are doing well.”
I also discussed with Dr. Hanson this morning that our ankle clinical outcomes are a bit more up and down than knees. This means that while many patients like CB do very well, it’s a bit tougher to predict than knees. This may be because so many ankle patients have significant instability which has never been detected. If this instability goes on for too long, huge bone spurs begin to form in an attempt to stabilize the joints. This can lead to a quasi-stable mess that’s very non-functional (the bone spurs can markedly decrease range of motion) and more difficult to treat. The upshot? if you have ankle arthritis, even if it’s mild, get your stability checked early and consider non-surgical therapies like prolotherapy and platelet rich plasma to tighten ligaments. If your ligaments stay lax for long periods of time, you may end up with a joint that’s difficult to treat!
NOTE: Regenexx-SD is a medical procedure and like all medical procedures has a success and failure rate. Not all Regenexx Sd can expect the same result.