ACL Surgery or Not? That tis the Question…

ACL surgery or not? A little Shakespeare this morning on an important issue. Over the past few years we’ve seen MRI evidence of knee ACL healing with stem cell treatment. I’ve blogged on some of these knee ACL images showing improvements with just an injection of stem cells rather than surgery.

Yesterday Dr. Schultz showed me the MRIs of an elite soccer player who like many young women had torn her ACL. Perhaps a better phrase is actually shredded her ACL. She wanted to avoid ACL knee surgery so she underwent an injection of her own stem cells into the knee ACL 3 months ago. In MM’s images above, the image on the left shows where the ACL fibers travel (yellow dashed lines). They should be tight and all heading in the same diagonal direction, instead what you see is a tangled mess of torn and hectic fibers. Now look at the post treatment MRI on the right. Now between the yellow lines you see nice fibers that all go the same diagonal direction. While she will likely need a second stem cell injection due to the severity of her shredded ACL (to get these fibers denser), she’s on her way hopefully to avoiding a surgery.

So rather than extensive downtime on crutches and months spent trying to rehab, she’s been able to exercise. In addition, there’s now a very good chance she’ll get to keep her original equipment rather than someone yanking out her ACL and putting another ligament in at way too steep an angle. In addition, we hope that with her original ACL intact, she will be able to dodge the early onset of arthritis that often plagues young women who have ACL surgeries at an early age. So hopefully with another treatment, MM will one day be another Mia Hamm!

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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