Can Patients with an ACL Tear Avoid Surgery?
POSTED ON 11/3/2015 IN Knee BY Christopher Centeno
One of the more astounding things I've seen stem cells do in my decade long use of the orthobiologic is heal ACL tears that should have needed surgery. We've amassed a great library of before and after films that never cease to blow me away. However, the proof as they say is in the pudding. So let's look at the most recent before and after MRI, maybe to date, and if you've been unconvinced this one will get you there. So one more time, can a precise stem cell injection help patients with an ACL tear avoid surgery? The ACL is a major stabilizer of the knee. When it's torn, it's not supposed to heal, so surgery is often used to replace the torn ligament. However, that procedure has it's issues. First, the graft goes in at a steeper angle than the original ACL, causing more compression of the cartilage. For example, most young adults who get the surgery will end up with arthritis by age 30. In addition, the position sense and strength of the knee is often never the same. Hence, the best possible solution for a torn ACL would be to heal the ligament in place. However, is this science fiction or can it really be done right now? Eddy is a middle aged, athletic attorney who first inured his knee in March of this year while playing basketball. He then went through two months of physical therapy and then he reinjured his right knee in May 2015. An MRI showed a complete ACL tear that would normally require surgery. In late summer, three months ago, he decided to avoid surgery and get a precise injection of his own stem cells into the tear with Dr. Schultz (Regenexx-SD procedure). 90 days later, he has near elimination of the pain at the back of his knee. Before the procedure, he would start limping after only 3 blocks, now he has no limitations. While all of that improvement in his pain and function is great to see, perhaps the most interesting thing was the change in his MRI report: Before: "...tear in the anterior cruciate ligament near it's origin." After: "No tears identified." The MRI on top shows a tear in the ACL (white vertical line through the light grey tissue in the white dashed circle). The one on the right from 3 months after the stem cell procedure shows no tear in the same place. The images below are a bit harder to look at since they're from a specialized ACL sequence that tries to catch the ligament lengthwise. However, you can still see the tear (now horizontal white line through the darker appearing ligament in the white dashed circle).
Again, on the right, the tear can't be seen.
The upshot? Convinced? As I said, the techniques we've pioneered with ACL tears never cease to amaze me. In addition, we're now on our third advancement in how the procedure is performed, allowing us to deliver more cells to the areas that need it the most and as a result, we're seeing better results than ever before. So will we need ACL surgery 10-15 year from now? While I think some severe tears may still require surgery, most of what now needs surgery will likely be relegated to the dustbin of medical history!
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