Lisa is a 52-year marketing executive who had been suffering with Achilles tendon pain for approximately nine months. She reported that the pain had dramatically worsened over the three months before consulting with me and she had pain scores of up to 7 out of 10 depending on her activity.
Initially she did not undergo stem cell treatment for her partially torn Achilles tendon. She instead underwent extensive conservative care during that time without even modest improvement in her pain and mobility. These therapies included deep tissue massage, physical therapy, ultrasound and dry needling.
Initial Diagnosis of Tendinosis and Partial Achilles Tendon Tears
She had recently undergone an MRI examination of her Achilles tendon. The MRI was significant for tendinosis with hyperintense T2 signal within the substance of the tendon. There were several small partial tears in the insertional fibers of the Achilles tendon. Mild bone marrow edema was seen in the posterior aspect of the calcaneus adjacent to the tendon insertion.
On examination, Lisa had mild diffuse swelling in the distal Achilles tendon with light erythema present. She was extremely tender to even gentle palpation of the Achilles fibers. There was a five-millimeter area of tendinosis notable just proximal to the distal insertion.
Achilles Tendon Stem Cell Injection Procedure
Given the patient’s age, and the chronicity of her injury, the decision was made to inject the tendon with a combination of adipose derived stem cells and bone marrow concentrate. The adipose tissue was harvested from her lower abdomen and the bone marrow was aspirated from her posterior iliac crest under live x-ray guidance.
The stem cell therapy procedure was performed on September 27th of 2016 and the injection carried out under ultrasound guidance. There were no complications during the stem cell tendon procedure and she was discharged to home with a pain score of 6 out of 10. She was told to take it very easy for the next month and that her only exercise she was to participate in was walking with slowly advancing distances.
The patient reported being very stiff and sore in the Achilles tendon for several days post-op, but did not require crutches.
Short Term Results From Stem Cell Therapy
The patient was seen in a followup on October 28th of 2016 at which time the tendon was re-injected with platelet rich plasma. On admission that day the patient reported pain scores of 1-4 out of 10. She stated that over the last two weeks she felt that her pain had diminished approximately 50% since her initial procedure. The tendon was injected with PRP at the area of tendinosis and the distal insertion. The patient was discharged with mild discomfort and allowed to slowly start advancing her exercise beginning in two weeks.
Lisa followed up on December 15th, 2016. On examination the tendon showed no signs of erythema and the swelling had completely resolved. Her range of motion had returned to 100% and she had no discomfort to palpation, deep flexion or full extension. The patient reported a pain score of 0/10 during the past 3 weeks. Lisa returned to full activity with no restrictions at that juncture.
Long Term Treatment Results
Lisa was seen again for re-evaluation at both 6 months and one year. She continued to report complete relief of her symptoms on both occasions. She had returned to full aerobic exercise as well as weight training, cycling, skiing and Pilates. She is thrilled with the results from her stem cell procedure and is happy to discuss her experience with potential patients.