A Confused Radiologist and an Improved ACL?

We have been helping patients avoid ACL surgery for many years now using the Perc-ACLR procedure. A humorous radiology report came across my desk on a patient treated by Dr. Markle that I thought was worth sharing. Let’s dig in.

Radiologists and Humor?

Radiology would not be the specialty you would pick as the class clown of medical school. Instead, these were the medical students who loved sitting in dark rooms. However, this radiology report was recently issued on one of Dr. Markle’s patients:

While that impression may not be funny to the average person, to us physicians that practice interventional orthopedics, this one is hilarious. Why? Because the radiologist seems perplexed how this ACL could have healed in two months as that’s not what he’s used to seeing. While these ACLs can look a little better or worse in that time frame, they usually don’t look like they were never injured in the first place. Here the ACL is outlined in red. On the left it looks blown out without structure and on the right, it looks like it has normal fibers traveling from point A to point B.  So how did Dr. Markle accomplish that?

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The Perc-ACL Procedure

I’ve been blogging on this procedure for about a decade. It’s not a magic stem cell procedure, but a highly precise injection of the patient’s own bone marrow concentrate into the ligament using precise fluoroscopic guidance that takes quite a while to master. To see what the procedure looks like, see my video below:

Dr. Markle performed this procedure on this patient two months prior to the second image. This is the image from this patient’s precise injection:

Let’s learn a bit more about this patient.

A Tennis Injury

Shelby is a 29-year-old who was first seen by Dr. Markle in March who was playing tennis and cut suddenly to the right and she felt an audible pop in the left knee. She immediately had pain and swelling in her knee and couldn’t bear much weight on that side. She had limited range of motion as well, so she went to an urgent care center. They tried to aspirate her knee, and it actually intensified the pain and made things worse. Her MRI showed a complete ACL tear with a large amount of fluid in the joint and more mild sprains of her MCL, LCL and MPFL ligaments. On April 6th she had the Perc-ACLR procedure performed and Dr. Markle also treated her other sprained ligaments.

The upshot? This patient did well with the Perc-ACLR procedure, which seems to have confused the radiologist. So here’s to treating many more ACL tears without surgery and confusing many more radiologists!

Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications. View Profile