ACL Surgery Alternatives: A Stem Cell Injection Can Get Rid of an Invasive Surgery

By Chris Centeno, MD /

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acl surgery alternatives

When you first start performing a new procedure, there are lots of unknowns. For example, which type of patient will this procedure help? What’s the best technique? How durable is the result? Hence, when we first began seeking ACL surgery alternatives using precise stem cell injections in 2011, we had many more questions than answers. However, now that we’ve been performing this procedure for seven years, we’re reaching the point of mastery. Case in point this morning is a very active adventure-sports enthusiast who decided to forego traditional ACL surgery and look into whether any ACL surgery alternatives existed that would allow him to return to his unusually high level of activity. His research revealed one did exist, and he received our groundbreaking ACL surgery alternative stem cell injection.

How Medical Procedures Progress

When ACL surgery first began, it was a game changer, especially for athletes. However, since it involves installing a poor copy of the original equipment in an invasive procedure, it was bound to be replaced at some point. Why? Keeping your own ligament allows for better alignment of the fibers in the direction of maximum force which is better than installing a faux ligament created from a tendon. In addition, you get to keep all of the position sensors in your own ligament, all of which help to control the knee muscles during activity. In the installed tendon, while position sensors are present, they can’t be hooked up to the central nervous system.

When we first started this procedure in 2011, we had a slew of questions. The first was, who could we treat? We started small by precisely injecting stem cells into patients who had partial ligament tears. This worked, so we tried a few patients with bigger complete tears without retraction of the ligament. Finally, we explored bigger tears and finally defined who would be a candidate and would not. In the end, we created an online tool only that can only be used by Regenexx network providers to more accurately define candidacy:

Next, we had to figure out where to place the stem cells. This was very difficult, as prior to our injection of the ACL under X-ray guidance (fluoroscopy), nobody had ever wanted to inject that ligament, and, hence, there was no textbook. We first tried ultrasound imaging and then fluoroscopy and realized that the latter provided a much more thorough injection:

So in the end, after many years, we finally had a reliable ACL surgery alternative procedure that we could hang our hat on. However, this knowledge was hard won, meaning little of it was intuitive. So while today there are more physicians offering this procedure, only those who have been taught by us and have access to our large database of successes and failures can perform this procedure on the right patients in the right way to maximize the odds of success.

Our Newest Patient Result

We have so many before and after ACL MRIs on this blog now that it’s getting difficult to find them all. This one is on a patient who had a complete tear in his ACL and was offered surgery. He was an avid skier and adventure-sports enthusiast, so he sought out ACL surgery alternatives. A simple Google search taught him that Regenexx was where the ACL stem cell procedure originated, so he flew to Colorado for treatment.

The patient’s pre-procedure MRI above on the left shows his tear. This is the blown-out and lighter area to which I’m pointing. I have outlined both ACLs in the images above (white dashed lines) so that you can get a sense of what you’re comparing. Now in the right image, note how much darker and tighter the ligament appears. The right image is six months after his precise ACL stem cell procedure performed by Dr. Williams here in Colorado.

However, all the great-looking MRIs in the world mean nothing if the patient can’t return to what he or she loves doing. To that end, if a picture is worth 1,000 words, a cell video sent by the patient showing him tearing up the slopes has to be worth more:

The upshot? We’ve been through almost a decade-long process learning how to fix torn ACLs without surgery and, in the process, developed one of the leading ACL surgery alternatives. In the meantime, realize that this procedure isn’t easy to perform and that any physician performing it must be trained by our group to ensure the procedure is performed properly. In addition, they also need to understand who is and isn’t a candidate, something that only Regenexx providers can do at this point!

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2 thoughts on “ACL Surgery Alternatives: A Stem Cell Injection Can Get Rid of an Invasive Surgery

  1. Bad timing

    Can someone who has already undergone ACL surgery in the past have this done in the future? Or is it that once you have a cadaver, what’s done is done?

    1. Regenexx Team

      Bad timing,
      Yes. A tear in a graft can be treated. Please see: https://regenexx.com/blog/acl-surgery-failure/ To see if your particular situation would be a Candidate, please submit the Candidate form here: https://regenexx.com/regenexx-acl-repair-for-torn-anterior-cruciate-ligament/

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.
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