Treating Severe Ankle Arthritis with Stem Cells
POSTED ON 1/12/2017 IN Foot and Ankle BY Christopher Centeno
We're hard on ourselves. Based on the almost 10,000 stem-cell-treated patients on whom we've tracked and recorded outcomes, we have noted several trends. Based on that data, we often tell patients that they're not great candidates for an injection of their own stem cells. Sometimes they prove us wrong. The video above was sent by a patient with severe ankle arthritis who got a stem cell injection here at our Colorado clinic a little less than a year ago. In this case, I love being wrong!
Ankle Arthritis—What You Should Know
The single biggest cause of ankle arthritis that we see consistently in the clinic is occult instability. This is where someone sprains an ankle and while they seem to recover, the ligaments that protect the ankle joints are stretched out. Over time, the slight extra motions in the ankle lead to breakdown in the joint, and arthritis develops.
Jim's Ankle Odyssey
Jim was evaluated by myself about a year ago. He had an 8-year history of ankle pain, which wasn't helped by the fact that as a firefighter he is required to carry heavy backpacks. The joint would also swell with hiking.
At that time, his MRI showed severe ankle arthritis with cysts in the bone and what's called a BML. This is an area in the bone that can cause pain and is swollen on the MRI. It's an indication of microfractures in the struts that support the structure of the bone. The surgical solution for this side was an ankle fusion. In this surgery, screws are placed across the many ankle joints to bolt them together and irreversibly stop motion. His other ankle had a stretched-out deltoid ligament with more mild arthritis. He also had irritated nerves in his low back.
Based on our registry data, I told Jim that his ankle with severe arthritis wasn't a good candidate. This is based on treating hundreds of ankle patients over the years and reviewing our registry data to figure out which ones do the best. However, the problem with looking at large amounts of data is that any one person can be an outlier and prove you wrong.
About a year ago, we treated all of these areas. This included precise injections into the arthritic joints using our proprietary HD-BMC technique as well as treating the stretched ligaments. Finally, we also injected some of his stem cells into the bone lesion using X-ray guidance.
How did Jim do? A video is worth a thousand words! See above.
The upshot? We're honest with patients and give them the benefit of the registry data we've collected. At the end of the day, we try to underpromise and overdeliver. In Jim's case of severe ankle arthritis, I'm very glad to have been wrong!
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