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Stem Cells Now Used to Treat Foot and Ankle Pain

Posted Jun 10 2012 1:47pm
For a very long time, I have been watching the stem cell research and debates and patiently (not really) waiting for a useful application in the foot and ankle.  Whether you are for or against this topic, this blog is not a debate on its use.  My blog today is to tell you about the patients I have used it on and their success.

I began to use it in my practice last December with skeptical ideas on how successful it could be.  I've been pleasantly surprised at the results.  Let's start with what the stem cells are.

I use AmnioMatrix.  This is amniotic fluid taken from mothers who have consented to have the fluid removed during C-sections.  There is absolutely no harm to mom or baby and this is not done prior to birth.  The fluid is then cryopreserved with no additives keeping the cells live for use when they are thawed and injected.  So why these cells?  Their job in the baby making process is to protect the fetus and help with development.  When you hear the term "my water broke", that's amniotic fluid.  When placed in an adult to the site of an injury or chronic pain area, these cells recognize what is missing or not normal and begin a healing process.  If you want to read more of about this, Applied Biologics will answer a lot of questions.

What have I used it for so far? Plantar fasciitis , Achilles tendonitis , neuromas , non-healing fractures , non-healing ulcers

So let's talk about some patients that have benefitted from this product.

The first one is Amy.  She is a very active 45 y/o mom and business professional who began having pain in her Achilles tendon after a long run.  This progressed to a large knot on the back of her Achilles tendon above where it inserts on the back of her heel.  We call this Achilles tendonitis or tendonosis .  She attempted resting, icing, physical therapy, good shoes.  No steroid injections are performed in a tendon area because this can cause rupture of the tendon.  I sent her for an MRI which came back as small micro tears in the tendon.  This means the tendon isn't completely torn, just very tiny tears causing the swelling and pain.  During all of this, she was not able to work out and her mood had dropped significantly at home and work.  We talked about her options and in the past, surgery to clean out the tendon was her only resort.  She decided to try the amniomatrix instead.

This did require surgery, but minimally invasive.  I made a very small incision on the side of the bump on her Achilles tendon.  I opened the protective sheath around the tendon and made several small holes in the bump called a microtenotomy.  This allowed a portal for the stem cells to reach inside the tendon.  I injected the AmnioMatrix stem cells all around the tendon, then carefully closed the sheath and skin.

She did very well during her recovery.  She had no pain at post op day 5 and never really had swelling or bruising.  She used her walking boot for 3 weeks and was able to walk without crutches at post op day 3. After crutches, she wore tennis shoes for 2 months and made sure not to do a lot of barefoot walking.  She started a light exercise program at week 4 and has progressed back to running at her normal pace with pain.  And her mood is dramatically better.

The next patient I want to talk about is Kathleen.  She is a 50 y/o financial advisor who suffered a fracture of one of her sesamoid bones.  The sesamoids are 2 small bones that lie under your big toe joint and help propel you forward when you walk.  I treated her like I would any fracture by placing her in a walking boot to reduce pressure and pain and ice.  Normally bone heals at 4-6 weeks.  After 3 months, she had no improvement in pain and X-rays showed the bone was not healing.  I ordered an MRI which showed the fracture without surrounding edema which means it had stopped healing.  Normally, the next step is surgery to remove the injured sesamoid.  But she was not happy with the possibility that her big toe would drift after surgery.  So we discussed amniomatrix.

This also required a small surgery.  Under anesthesia, I used a large pin and drilled several holes through the fracture line and the bone.  This was done under a live X-ray in the OR.  I then injected the entire area with AmnioMatrix.  Post op she wore her boot for 6 weeks.  Was pain free at week 2, could move her toe without pain at week 3.  She started wearing tennis shoes at 6 weeks and began gradual increase in her activity.  She remains pain free and is doing very well in regular shoes.

I've got lots of stories like the 2 above and over the next several weeks will be sharing those with you so check back often.  If any of these stories make you say "Hey, that's me", come see me!


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