Big Surgeries, Big Complications

by Chris Centeno, MD /

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ankle1

Just getting back to blogging after a much needed vacation.  In the last few decades, there has been a big move towards minimally invasive procedures, essentially making smaller and smaller incisions to accomplish the same medical goal.  The reason?  The bigger the surgery, the bigger the potential for complications.  Take the patient I saw this morning for the Regenexx-C procedure on his ankle.  This gentleman had an ankle arthroscopy to remove a bone spur caused by years of running.  However, he contracted MRSA (a super bacteria that is very hard to kill with antibiotics) during the arthroscopy and then underwent 12 additional surgeries over the next two months.  Because the skin on the outside of his ankle was pretty chewed up, they had to take a skin/muscle graft (flap) from another area and bring it down to the lateral ankle (the large “bump” you see on the outside of the ankle in the picture above).  As a result of the MRSA all cartilage in his ankle was also chewed up and the medial talus also partially collapsed.  While MRSA infections are not common with arthroscopy, I use his case this morning to illustrate a point.  We see many patients in our practice where big surgeries have produced big complications.

This patient was treated with the Regenexx-C (cultured stem cell injections).

A second example is also illustrative.  Last week I met with a patient considering the Regenexx-C procedure for a labral tear.  She had started with a frozen shoulder (adhesive capsilitis) due to the original shoulder labrum tear.  The help this, arthroscopy was combined with manipulation under anesthesia.  While this MUA procedure can help free up shoulder movement in patients who have very little shoulder range of motion, in her case it tore up the joint capsule leaving an unstable shoulder.  In particular, the damage was to the superior lateral fibers that the shoulder hangs on when it’s at rest at your side.  Without these ligaments, the shoulder becomes grossly unstable, and all of the muscles of the shoulder are in constant “overdrive” spasm, trying to keep the shoulder stable.

The take home message, the advent of regenerative medicine techniques will allow more minimally invasive procedures to be used in more patients.  There will still be a place for bigger surgical procedures and undoubtedly regenerative medicine will be mixed and matched with surgical and non-surgical approaches alike.  However, the ability to perform more procedures through a needle or very small tools, will allow complications rates to fall.  Here’s to the future!

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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Regenerative procedures are commonly used to treat musculoskelatal trauma, overuse injuries, and degenerative issues, including failed surgeries.
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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
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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
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  • And more
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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
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  • Other Knee Ligaments / Tendons & Overuse Injuries
  • And more
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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
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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
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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
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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
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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
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