Yet Another Patient Avoids Surgery: Regenexx ACL Stem Cell Procedure

POSTED ON 7/27/2016 IN Knee BY Christopher Centeno

ACL stem cell procedure


Helping patients avoid knee surgery with our precise injection ACL Stem Cell Procedure is becoming so routine that I often miss the before and after images as they come in and are reviewed. The before and after above is one that I found when I asked our doctors for an image to share with a writer working on a story. It's pretty amazing stuff, so I thought I'd share the story behind it. Basically, a guy with a complete ACL tear that would have required surgery had just a stem cell injection instead. In most clinics that's groundbreaking, but at many Regenexx clinics, it's routine.

The Top 5 Problems with ACL Surgery


The ACL is the major front-back and rotational stabilizer of the knee bones. It's usually torn in sports injuries, and a blown ACL can leave the knee unstable. It seems like it's a rite of passage for every athlete to get his or her ACL surgically "fixed," but it's important to note that the ligament installed is different from the original equipment in some significant ways:

  1. The new ACL graft is inserted at a much steeper angle than the original, leading to differences in how the new ligament works to stabilize the knee and making it more likely to tear.
  2. If the graft ligament is taken from the patient, the muscle from which it is harvested will be made weaker.
  3. The new ACL graft has no working position sensors, so the patient loses position sense in that knee.
  4. The normal opposite knee ACL is more likely to tear after the injured knee has an ACL repair surgery.
  5. ACL surgery won't prevent or change your arthritis risk.

The History of Our Groundbreaking ACL Stem Cell Procedure


When you invent a new medical procedure, there are no textbooks to review. Everything about it has to be created from the ground up. In this case, John Schultz and I began working on the procedure in 2010 as there was no reliable way to get into the ACL with a needle using imaging guidance. It was hit or miss to start, meaning that confirming that stem cells were in fact being placed into the ACL was easy in some injection procedures and impossible in others. Hence, a new and different procedure needed to be developed. I studied anatomy texts, and by late 2011 and early 2012, I had a reliable way to get stem cells injected precisely into the ligament. This technique continued to evolve, and by 2014 I had a procedure that was capable of injecting all parts of the two-bundle ACL ligament.

Our Newest ACL Patient


Since we developed this procedure, we have performed more ACL Stem Cell Procedures than any other group worldwide. This latest patient, Eddy, is a 44-year-old athletic attorney who injured his knee in March of last year during a crossover in basketball. He first had physical therapy and then re-injured that knee in May of 2015 and was diagnosed with a complete ACL tear. The patient was a surgical candidate but sought some way to keep his original ACL intact, so he was evaluated and treated by Dr. Schultz in July of 2015. Dr. Schultz precisely placed Eddy's own stem cells into his ACL using imaging guidance and our patented same-day stem cell technique—Regenexx-SD. The patient's before and after images are above, with the right images being about three months postinjection. The course of the ACL ligament is outlined by the yellow triangles. In the left pre-injection MRI, note the very bright oblique tear in the ligament above, located inside the yellow-dashed circle. In the image on the right, note that the same area no longer contains that tear. This is consistent with his reported results and the ligament becoming firmer and normal in strength on exam.

Make Sure Your Doctor Knows How This Is Done


This is not a simple procedure to perform. We're seeing some doctors beginning to claim that they can do this using ultrasound imaging, but, regrettably, that will result in a suboptimal injection and result. The issue is that the ligament comes from a region called the trochlear groove, which is buried deep inside the middle of the knee. There simply is no way to see this part of the ligament well under ultrasound guidance. Hence, if ultrasound is used to place the cells, a large, damaged part of the ACL will go without stem cells. In addition, both bundles of the ligament must be injected, which is very difficult to master. The Interventional Orthopedics Foundation (IOF) gives coursework in how this procedure is done, so make sure your doctor has taken and passed that advanced knee course given by the IOF. If he or she hasn't, then it's highly likely you're getting a watered-down version of the procedure. The upshot? The Regenexx ACL Stem Cell Procedure is a groundbreaking advance that will save many patients from surgery and allow them to keep their own ACL ligaments. We invented this procedure and continue to treat many patients. We've published the world's first knee ACL stem cell research paper and have a second one on the way. If someone offers you this procedure, make sure he or she has been trained through the IOF as that's the only coursework being given by physicians experienced in how this is done.  

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