ACL Surgery Alternative: Imaging Analysis in our New Stem Cell ACL Tear Studies

By Chris Centeno, MD /

Receive a Regenexx® Patient Info Packet by email and learn why it's a superior regenerative solution.

acl surgery alternative

Can a stem cell injection be an ACL surgery alternative? The ACL is the major stabilizing ligament of the knee. ACL tears are a big deal, especially in young athletes. In women’s soccer, torn knee ACLs seem to be an outright national epidemic. The surgery for this procedure is very invasive and installs a new ligament without many of the natural properties of the original equipment. Healing an ACL tear would be nothing short of miraculous, allowing the athlete to keep that ligament. But can this be done? We’ve been seeing evidence of healing of torn ACLs for years using a very exacting injection of stem cells directly into the torn ligament. To prove the point, we’re now funding two studies to make sure that the data gets into the peer reviewed medical literature.

When a doctor looks at an MRI of the ACL, it’s a very qualitative thing, meaning whether the ACL is healed is based on how the picture looks and how a reader interprets that image. However, research journals like quantitative data like blood tests and other diagnostics that spit out a number. So is there a way to bridge that gap between the two and use a quantitative way to see if the ACL ligament is better after a stem cell injection? Yes. Our research team is using MRI analysis software to turn the ACL before and after images into pixel intensity histograms.

A histogram is a graph of the frequency of the appearance of something in a data set. Since we know that on the images where we see the ACL a better ligament is darker and a weaker or damaged ligament is lighter, the imaging analysis software plots the number of pixels in the ACL based on how light or dark they are. A shift toward dark pixels (for our purposes the left skew of the data) tells us in a quantitative way that the ACL looks better.

Look at the images above (click on the thumbnail to see a bigger PDF). Note that the histogram graph for the image has the darkness of the pixels on the x-axis and the number of pixels that were that shade of black, grey, or white on the y-axis. So the position and height of each of these bars is important. Now look at mean of the above histogram, the average pixel position is about 34 1/2. Now look at the histogram below that was created from an image taken a few months after the stem cell injection.  The mean has shifted to the left (darker pixels) and is now a bit more than 25. This means that the average pixel value in the ACL got darker from the before image to the after image.

We’ve used this new imaging analysis technique on a number of patients and are readying a case series with objective measurements in ACL stem cell treated knees for submission to a medical journal. Since we’ve validated this method and it has very high inter-rater reliability (Correlation Coefficient >0.9), we’ll use it again for our knee ACL tear randomized controlled trial that’s now recruiting. The upshot? We’re seeing torn ACLs look much better on MRI with very precise stem cell injections and these patients are also reporting improvement. Again, our goal is nothing less than changing how Orthopedic care is delivered, so substituting a specialized injection for a big knee surgery is a good start!

Category: Knee, Regenexx-ACL

Chris Centeno, MD

Regenexx Founder

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

Get Blog Updates by Email

Get fresh updates and insights from Regenexx delivered straight to your inbox.

Regenerative procedures are commonly used to treat musculoskelatal trauma, overuse injuries, and degenerative issues, including failed surgeries.
Select Your Problem Area
Shoulder

Shoulder

Many Shoulder and Rotator Cuff injuries are good candidates for regenerative treatments. Before considering shoulder arthroscopy or shoulder replacement, consider an evaluation of your condition with a regenerative treatment specialist.

  • Rotator Cuff Tears and Tendinitis
  • Shoulder Instability
  • SLAP Tear / Labral Tears
  • Shoulder Arthritis
  • Other Degenerative Conditions & Overuse Injuries
Learn More
Cervical Spine

Spine

Many spine injuries and degenerative conditions are good candidates for regenerative treatments and there are a number of studies showing promising results in treating a wide range of spine problems. Spine surgery should be a last resort for anyone, due to the cascade of negative effects it can have on the areas surrounding the surgery. And epidural steroid injections are problematic due to their long-term negative impact on bone density.

  • Herniated, Bulging, Protruding Discs
  • Degenerative Disc Disease
  • SI Joint Syndrome
  • Sciatica
  • Pinched Nerves and General Back Pain
  • And more
Learn More
Knee

Knees

Knees are the target of many common sports injuries. Sadly, they are also the target of a number of surgeries that research has frequently shown to be ineffective or minimally effective. Knee arthritis can also be a common cause for aging athletes to abandon the sports and activities they love. Regenerative procedures can be used to treat a wide range of knee injuries and conditions. They can even be used to reduce pain and delay knee replacement for more severe arthritis.

  • Knee Meniscus Tears
  • Knee ACL Tears
  • Knee Instability
  • Knee Osteoarthritis
  • Other Knee Ligaments / Tendons & Overuse Injuries
  • And more
Learn More
Lower Spine

Spine

Many spine injuries and degenerative conditions are good candidates for regenerative treatments and there are a number of studies showing promising results in treating a wide range of spine problems. Spine surgery should be a last resort for anyone, due to the cascade of negative effects it can have on the areas surrounding the surgery. And epidural steroid injections are problematic due to their long-term negative impact on bone density.

  • Herniated, Bulging, Protruding Discs
  • Degenerative Disc Disease
  • SI Joint Syndrome
  • Sciatica
  • Pinched Nerves and General Back Pain
  • And more
Learn More
Hand & Wrist

Hand & Wrist

Hand and wrist injuries and arthritis, carpal tunnel syndrome, and conditions relating to overuse of the thumb, are good candidates for regenerative treatments. Before considering surgery, consider an evaluation of your condition with a regenerative treatment specialist.
  • Hand and Wrist Arthritis
  • Carpal Tunnel Syndrome
  • Trigger Finger
  • Thumb Arthritis (Basal Joint, CMC, Gamer’s Thumb, Texting Thumb)
  • Other conditions that cause pain
Learn More
Elbow

Elbow

Most injuries of the elbow’s tendons and ligaments, as well as arthritis, can be treated non-surgically with regenerative procedures.

  • Golfer’s elbow & Tennis elbow
  • Arthritis
  • Ulnar collateral ligament wear (common in baseball pitchers)
  • And more
Learn More
Hip

Hip

Hip injuries and degenerative conditions become more common with age. Do to the nature of the joint, it’s not quite as easy to injure as a knee, but it can take a beating and pain often develops over time. Whether a hip condition is acute or degenerative, regenerative procedures can help reduce pain and may help heal injured tissue, without the complications of invasive surgical hip procedures.

  • Labral Tear
  • Hip Arthritis
  • Hip Bursitis
  • Hip Sprain, Tendonitis or Inflammation
  • Hip Instability
Learn More
Foot & Ankle

Foot & Ankle

Foot and ankle injuries are common in athletes. These injuries can often benefit from non-surgical regenerative treatments. Before considering surgery, consider an evaluation of your condition with a regenerative treatment specialist.
  • Ankle Arthritis
  • Plantar fasciitis
  • Ligament sprains or tears
  • Other conditions that cause pain
Learn More

Is Regenexx Right For You?

Request a free Regenexx Info Packet

REGENEXX WEBINARS

Learn about the #1 Stem Cell & Platelet Procedures for treating arthritis, common joint injuries & spine pain.

Join a Webinar

RECEIVE BLOG ARTICLES BY EMAIL

Get fresh updates and insights from Regenexx delivered straight to your inbox.

Subscribe to the Blog

FOLLOW US

Copyright © Regenexx 2019. All rights reserved. | Privacy Policy

*DISCLAIMER: Like all medical procedures, Regenexx® Procedures have a success and failure rate. Patient reviews and testimonials on this site should not be interpreted as a statement on the effectiveness of our treatments for anyone else.

Providers listed on the Regenexx website are for informational purposes only and are not a recommendation from Regenexx for a specific provider or a guarantee of the outcome of any treatment you receive.

LinkedIn
Email