Healing another Knee ACL Ligament with Stem Cells?
POSTED ON 9/12/2012 IN Results BY Christopher Centeno
Can stem cells heal a complete knee ACL tear injury? We've already reported on patients where we were able to fix high grade ACL tears with just an injection of stem cells. This looks like another such patient. LW is a 43 year old woman seen in April by Dr. Hanson for a 1 month old knee injury that occurred while playing tennis. She stopped short suddenly and felt a pop in the knee and was able to continue playing until the knee finally gave way later in the game. Her MRI (above on the left) showed a grade 3 complete ACL tear and also had a tear in her MCL. Dr. Hanson performed a diagnostic needle arthroscopy (a new technology that allows us to see down the end of a needle rather than a traditional much bigger and more invasive arthroscope). This study procedure proved that despite her MRI showing what looked like a complete tear (the white line seen at the yellow arrow that cuts across the ACL), that the fibers of the knee ACL ligament were mostly intact. As a result, Dr. Hanson performed an x-ray guided Regenexx-SD stem cell injection on 4/12/12. Based on the imaging above, the ACL is healing nicely. The image on the right clearly shows that the white tear line present in the MRI on the left (yellow dashed circle) isn't present in the MRI on the right. In fact, these images aren't the best comparisons (the coronal slices look better), so we're getting more sagittal MRI slices through the middle in a second follow-up MRI. How is she feeling? Here is some of her report (it was lengthy): "By 6 weeks post procedure: I was able to walk unbraced, full weight bearing, no instability. Range of motion was in the 70% range. I was able to straighten to a few inches off the floor if sitting down, I was not able to get into a full squat or sit fully on my feet. I began walking 3-5 miles daily, no swelling, and no instability, there were some sharp pains here and there in the front of the knee to the right bottom of knee cap (toward the inner knee). Currently @ 4.5 months out:
- There is zero instability. I have experienced zero giving way.
- I have not tried anything harder than walking for distance / biking for distance- meaning no lateral movement sports yet because I want a confirmed MRI before engaging.
- I have hiked up and down some rooty hills in the woods with no issues. Downhill I hear is the worst on an ACl, I can go straight down a steep hill with 0 problems, including at a light jog. I can do jumping jacks. I have played chasing games with my kids around chairs and all around the house where you have to run sort of sideways to make it around turns, I am not going at full speed, but even at heavier than a jog, there have been no stability issues.
- I have been on the beach with no stability issues
- In June, I shoveled up and moved a tree, with jumping onto the shovel to get leverage under the tree with no stability issues
- The pain in the front right inner portion of the knee is no longer sharp, I do still feel 'something' there, but its harder to identify
- I can squat down to the floor and get back up without arm assistance, and I can straighten my leg fully. I can hop for distance to a similar distance on both legs, I can stand on one foot, I can cross-over hop.
- I can sit on my knees legs bent, but there is still a slight differential in the treated knee of about maybe a centimeter where I am not able to put 100% weight on the treated side, but its really close
- Overall I would say I am at 90ish%, with some stuff still going on. I would classify the 'stuff' as follows: 1. The treated knee has a heaviness feeling to it that the untreated knee does not have; 2. Sometimes I do not feel that I am walking with the same gait on both sides, or if standing still balancing the same on both sides; 3. Humidity seems to affect how much I feel any of these things. Today there is no humidity and treated knee feels near normal."
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