A Maximally Damaged Ankle and Surprising Results

by Chris Centeno, MD /

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

When I first met Don and he showed me his ankle, I think I said or thought, “Wow!” It was twice as big as his other ankle due to the surgical free flaps, and his MRI looked like a bomb had gone off in his talus bone. When we discussed whether stem cells could help, I think he could read my body language, which loudly said, “Uhhhh, maybe?” That’s why this is a fun blog post to write, as Don ultimatley surprised me and then some.

Don’s Ankle

Don fractured his ankle back in the ’80s and had hardware surgically placed to help his damaged bones mend. The ankle then got infected and the hardware was removed, and many surgeries followed, including a free-flap surgery. In this case, that meant taking a muscle from his calf and sewing it over the nonhealing and infected bone to bring more blood supply and healing potential to the area. What he ended up with was an ankle that looked like a tumor had grown around it. That worked reasonably well, until about 3–4 years ago when he began to get arthritis in the main ankle joint. By the time he walked into the clinic for me to check this and other problems, his pain was an 8 out of 10 on medications.ankle anatomy mri

The MRI animated GIF above slices through his ankle sideways. I’ve included one of the slices to the left so you can get oriented. His talus is the oddly shaped bone in the middle, which is where I want you to focus your attention on the image. This bone is one of two (the other being the tibia) that make up the largest ankle joint.

On this type of MRI sequence, the normal bones are black. The bright areas you see in the talus bone above as the slices fly by are areas where the bone is fractured and never fully healed. Any white in this bone is abnormal, but the MRI shows that some of these fractures communicate with the tibiotalar joint, which is not good. In summary, his talus bone is a fragmented mess that never fully healed.

Could we help this ankle?

Don’s Stem Cell Plan

Looking at the severity of what we were dealing with, I steered Don in the direction of cultured stem cells. This means that at our licensed advanced-stem-cell-treatment site in Grand Cayman, we would grow the cells to bigger numbers. This not only made sense for this area, but we had his back and shoulder to treat as well. Using culture expanded cells would make it much more likely that we would have enough cells to treat everything.

I was very concerned that we might have to inject not only into the tibiotalar joint but also into the talus bone. However, that would risk the bone further fragmenting and falling apart; hence, we decided to only treat the joint and hope the cells would make it into the damaged and fragmented bone. This made sense, as there seemed to be actual physical communications between the joint and the pieces of the talus bone.

So how did Don do? He reported to me today that after his treatment in May, some seven months ago, his ankle pain is now down to a 2 out of 10, and he’s off medications. He went skiing this past weekend, and he’s back to activities he couldn’t dream of before. In summary, he did very well.

The upshot? Don’s recovery surprised the heck out of me. However, it goes to show you that even when we place patients in the poor category for a stem cell procedure, sometimes they surprise us. In Don’s case, I’m eager to see a recent MRI and have ordered one. In the meantime, I’m glad that he’s pleasantly surprised and has become our newest Regenexx evangelist!

The Regenexx-C procedure is not approved by the US FDA and is only offered in countries via license where culture-expanded autologous cells are permitted via local regulations.

Leave a Reply

Your email address will not be published. Required fields are marked *

2 thoughts on “A Maximally Damaged Ankle and Surprising Results

  1. Susan Dempster

    I broke my ankle several years ago, hardware was put in but now I have painful arthritis, and my goot/Ankle Surgeon wants to fuse my cuneiform navicular joint.
    I don’t want that because it’s very painful and assoc with a long recovery!
    I’m checking into Regenex. I am going to a doctor in Oakhurst. NJ to see.if I’m a possibility.
    I’ve worked on clinical studies as a nurse. But is this procedure FDA approved? I thought it was!
    Is it always best to go to the Cayman Islands? I know they can grow stem cells there but is that what I should do?
    I’m far from rolling in money … the price would be prohibited, I think! It’s my ankle, and I’m in pain!
    I’m now in contact with Dr. AMERSO in Oakhurst, NJ
    I WILL BE SEEING HIM ON FEBRUARY 5 TH. I’M NERVOUS! WHAT IF I PAY LOTS OF MONEY AND IT DOESN’T WORKNOW?
    I’D LOVE TO BE CONTACTED BY someone else in my predicament !!

    1. Regenexx Team Post author

      Susan,
      You’ll be in good hands! The initial exam is covered by insurance if you’re in network, and Dr. Amoroso will evaluate the situation and tell you honestly whether he thinks we can help, and if so, what he thinks the best course of action would be. That could include the cultured procedure in the Cayman islands if more stem cells than can be obtained in a same day stem cell procedure would be needed. The vast majority of patients are treated with the same day stem cell procedure. Here is more information abot how we treat foot and ankle issues; scroll down to see video of ankle procedure: http://www.regenexx.com/the-regenexx-procedures/ankle-surgery-alternative/

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.