Regenexx ACL Repair vs Reconstruction Surgery for Knee ACL
Today I’d like to highlight a patient named Joe’s story. Joe is unique in that he has had the non-surgical Regenexx Perc-ACLR procedure which uses your own cells injected via a small needle, and a surgical ACL reconstruction, so he can compare the two. So lets take a look at Regenexx ACL Repair vs Reconstruction Surgery.
What Is the ACL?
Before we get to Joe’s Story let’s just do a quick recap of what the ACL is. The ACL stands for Anterior Cruciate Ligament. It lives in the middle of the knee and it’s designed to stabilize the tibia (lower leg bone) on the femur (upper leg bone). It can be injured or torn during sports such as skiing, soccer, basketball, etc. Injury usually occurs with twisting of the knee while the foot is planted or direct trauma. The body has some ability to heal some injuries on its own and physical therapy can help compensate for the ligament weakness by helping the biomechanics and muscular strength. However, many patients that have continued problems opt for surgery, or have been told that’s their only option. But the surgery is far from perfect so we invented our Regenexx Perc-ACLR procedure . In the comparison of the Regenexx ACL Repair vs Reconstruction, the Regenexx Perc-ACLR procedure is often a better option than surgery for the right candidates. This involves precise injections of your own body’s healing factors directly into the ACL.
I first met Joe in 2016. At that time, he had a ski injury resulting in a complete but non retracted tear of his right knee ACL. That means the ACL was torn through but the fibers were still aligned or some fibers were still connected and not snapped back like a rubber band. He also has a flap tear of the medial meniscus (inner shock absorber) and we found instability of the MCL (inside knee ligament) and posterior lateral (back and outside) corner of his knee on ultrasound. Additionally, he had some chronic pain in his opposite left knee. This was mostly patella femoral syndrome where the tendons and ligaments that help the knee cap move in its groove were weak. Also the left knee had laxity in his ACL and PCL as well but no tears. I told him he was a fair candidate for treatment and he was ok with proceeding with precise image guided bone marrow concentrate (containing stem cells) and PRP injections to the ACL and multiple specific areas in each knee. He achieved 60% improvement from this and the ACL did appear to improve in appearance on a repeat MRI (the loose/torn fibers were connecting again). We decided to repeat stem cells to continue improvement. After the second procedure he was able to get back to skiing pain free with good stability. Additionally, the ACL on a repeat MRI looked near normal. He was very happy with the results and his initially injured right knee that had 2 stem cell treatments felt better than the non injured left knee! He was able to get back to all of his activities and avoid a major surgery on both the ACL and meniscus. This is important because surgery has more risks like infection, or the graft not healing, and well as longer recovery. Also, the surgery has not been shown to reduce early arthritis and the ACL graft is inferior to a native ACL as it is put in at a different angle and the position sensors from a normal ACL are missing. Additionally, we now know that the most common meniscal surgery a meniscectomy (removing part of the meniscus) puts patients at much higher risks of early arthritis and with better studies not shown to be better than sham surgery or just physical therapy.
Because Joe was doing so well, he continued to be very active for 2 years. He was back country skiing when he had a freak accident fall in which he landed awkwardly and twisted his right knee. Since the knee was feeling strong since his stem cells and all the rehab after he thought the injury wasn’t too bad but unfortunately this time a new MRI showed he did completely tear his right knee ACL with retraction this time. Because of this unfortunately, we told him he was not a candidate for our Regenexx Perc-ACL procedure and he had to have ACL reconstruction. However, knowing that this still has the chance of failure, the surgery can create another trauma to the cartilage causing early arthritis, and he had other injuries to the knee that surgery would not address, we decided to do our Regenexx Procedure after surgery. The goal would be enhancing the healing of the new ACL surgical graft, treat the other mildly injured areas such as the meniscus, and the other ligaments (MCL, LCL, ALL). Also they took a part of his hamstring tendon for the ACL graft so we treated the harvest site to help strengthen the weakened area of that tendon as well. We also did a tune up to the left knee as it was ok but not perfect. Joe is of our mindset of being “Proactive” to treat minor problems that are easy to treat before they blow up until larger problems.
Joe’s Current Status
This is Joe’s email response to me 4 months after that Regenexx treatment/ 6months after ACL surgery (ACLR):
“My right knee (and left) has been doing great! I really couldn’t ask for a smoother recovery from ACLR. I recently hit 6 mons and have been easing back into skiing and that’s been going great! I’m progressing everything slowly, of course, but never have any pain in any of my sports or activities. I still have pretty significant strength and size deficits (the stem cell-only recovery is a massive win there compared to surgery!) but it’s getting better everyday and skiing is a lot more fun than wall sits for quad mass!
Having done the stem cell treatment and the surgery as well, I wanted to offer that I’d be happy to answer questions if you ever have prospective patients (especially skiers, I know back in 2016 I was struggling with the initial decision) looking to chat with another patient. The rehab from the surgery is significantly more difficult both physically and mentally. So far, I have a great outcome and I’m sure the treatment with you was a factor in really solid healing!
Welcome to a new decade — my first year there could have been better but I’m extremely optimistic 2021 will be better than last year for myself and a lot of people!”
Joe’s ACL Progression Below:
Bottom Line about Regenexx ACL Repair vs Reconstruction
Joe had a successful Regenexx Perc-ACLR procedure at our clinic like many other of our ACL patients and that got him back skiing. Unfortunately, a freak accident caused an ACL tear that we were honest to tell him we could not treat directly but were able to improve his recovery from surgery. We are the experts in Interventional Orthopedics and regenerative medicine and have tons of patients that have done great after our Perc-ACLR procedure and have published papers on patient’s improvement. We also are completing a randomized control trial of ACL stem cell procedure versus physical therapy to add to that evidence of success. If you or anyone you know has been told they have an ACL tear, contact us to see if you are a candidate for the Regenexx ACL Repair vs Reconstruction Surgery for ACL tears, which uses your own cells to avoid surgery, or to potentially enhance surgery if that is needed.