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Knee pain can happen suddenly making simple steps almost impossible.  What is the ACL?  Is ACL surgery a major surgery?   How much does ACL Stem Cell Treatment Cost?  Is there a nonsurgical alternative to treat ACL tears?  Let’s dig in.

What is the ACL?

Ligaments are thick bands of connective tissue that connect one bone to another. The Anterior Cruciate Ligament (ACL) is a very important ligament in the knee that connects your thigh bone to your shin bone.  It provides stability and limits forward and rotational movement.  Cruciate means cross, which is shaped that is made by the ACL and PCL in the knee.  The ACL is susceptible to an injury that can occur as a result of trauma, and rapid pivoting and cutting movements.  ACL tears account for 64% of athletic knee injuries in pivoting sports resulting in 120,000- 200,000 ACL reconstructions annually in the United States (1).

Is ACL Surgery a Major Surgery?

Absolutely!  ACL surgery is a major surgery that involves cutting out the torn or injured ACL and replacing it with either a cadaver graft or the patient’s own patellar or hamstring tendon.  The graft or tendon is then secured by anchors that are placed into the thigh and shin bones (2).  The procedure is performed in a hospital or ambulatory surgery center with a general or spinal anesthetic lasting one to two hours.

Can Stem Cells Repair ACL?

Yes!  The Centeno Schultz Clinic pioneered the use of bone marrow concentrate in the treatment of ACL tears.  The procedure is called the Perc-ACLR (percutaneous ACL reconstruction) and was developed in 2011.  The procedure starts with the extraction of bone marrow from the iliac crest ( waist bone) which is processed and concentrated in a state of the art laboratory.  The bone marrow concentrate is then precisely injected under x-ray guidance into the ACL tears.  To date, we have published two studies in peer-reviewed journals (3) (4).

In the 2018 paper,  29 patients with symptomatic grades 1,2, and 3 ACL tears underwent treatment with Per-ACLR.   At 8.8 months 77% of patients demonstrated significant improvement  (4)  This is a challenging procedure that your PCP and orthopedic surgeon can not perform.  To watch an ACL stem cell treatment performed by Dr. Markle please watch the video below.

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How Much Does it Cost to Get Stem Cell Injections?

ACL stem cell treatment cost varies significantly depending upon what is injected, by whom and how.

What

Different clinics inject different substances which can confuse patients.   PRP injections are less expensive than bone marrow concentrate injections.  Birth tissue products contain no live and viable stem cells as previously reviewed.  Bone marrow concentrate was used in both of our peer reviewed publications demonstrating successful repair of ACL tears.

Whom

Years of training and years of experience translate to improved clinical outcomes.  Injections by a nurse or PA will cost less than those performed by a board-certified, fellowship-trained physician.  The latter is the standard of care at the Centeno-Schultz Clinic

Where

Blind injections performed in a doctor’s office will be less expensive than procedures performed in a full equipped procedure suite that includes oxygen, suction, IV’s, resuscitation medication, resuscitation equipment, x-ray, and ultrasound.  At the Centeno-Schultz Clinic all procedures are performed under x-ray or ultrasound guidance in a fully equipped procedure suite.

What is required to successfully treat ACL tears?

  • The ability to accurately place a needle into both bundles of the ACL and confirm it with contrast
  • The ability to accurately place a needle into the origin, mid-portion and insertion of the ACL  (where the ACL starts, its midpoint and where it ends)
  • Intermittent x-ray to document the accurate spread of contrast in the ACL fibers

At the Centeno Schultz Clinic, we are experts in the treatment and management of ACL tears.  Board-certified, fellowship-trained physicians perform all the ACL injections with x-ray guidance to confirm the accurate placement of the cells.  ACL stem cell treatment cost at the Centeno-Schultz Clinic is approximately $6000 which includes the bone marrow aspirate, processing of bone marrow and precise re-injection of cells.  For many patients this can eliminate the cost of treating other things in the future.  To review our clinical results to date on ACL tears please click here.

No discussion about cost is complete without also discussing the savings.  What are the savings for those who elect for ACL stem cell treatment?  The largest by far is your ability to keep your own native ACL with double bundles which is perfectly situated in your knee and are rich in fibers that inform us of our position.  ACL surgery excludes this as your ACL will surgically be removed and replaced with a SINGLE graft or tendon that has a high risk of tears and knee instability.  Surgical grafts are inserted at very steep angles due to technical constraints which can result in graft/tendon failure and knee instability.  Finally, there are very important fibers within the ACL that provide critical information about your position in space.  Muscle control and performance are compromised after ACL surgery as many of the locational fibers have been removed (5).  Balance is also compromised in patients one year after ACL reconstruction (6).

How Can I Heal my ACL Naturally?

Yes.  The Perc-ACLR (percutaneous ACL reconstruction) utilizes a patient’s own bone marrow concentrate and platelets that are injected under intermittent x-ray guidance into the tears in the ACL. The procedure enables patients to avoid the significant complications associated with surgery and extensive rehabilitation.

In Conclusion

The Anterior Cruciate Ligament (ACL) is a very important ligament in the knee that provides stability and limits forward and rotational movement.  It is susceptible to injury from trauma and pivoting sports.  ACL surgery is real surgery as the injured ACL is surgically removed and replaced with a cadaver graft or the patient’s tendon.  The Centeno-Schultz Clinic pioneered the use of bone marrow concentrate in the treatment of  ACL tears.  ACL stem cell treatment cost varies depending upon what is injected, how it is injected and by whom.  ACL stem cell treatment cost at the Centeno-Schultz Clinic are approximately $6000. The real saving with ACL stem cell treatments is the patient’s ability to keep their own ACL which has two bundles, is perfectly aligned in the knee and is rich in positional fibers. The Perc-ACLR (percutaneous ACL reconstruction) is an effective, nonsurgical treatment option that avoids the complications associated with surgery and extensive rehabilitation.


1.Kim S, Bosque J, Meehan JP, Jamali A, Marder R. Increase in outpatient knee arthroscopy in the United States: a comparison of National Surveys of Ambulatory Surgery, 1996 and 2006. J Bone Joint Surg Am. 2011;93(11):994-1000.DOI: 10.2106/JBJS.I.01618.

2.Raines BT, Naclerio E, Sherman SL. Management of Anterior Cruciate Ligament Injury: What’s In and What’s Out?. Indian J Orthop. 2017;51(5):563–575. doi:10.4103/ortho.IJOrtho_245_17.

3.Centeno CJ, Pitts J, Al-Sayegh H, Freeman MD. Anterior cruciate ligament tears treated with percutaneous injection of autologous bone marrow nucleated cells: a case series. J Pain Res. 2015;8:437-47.

4. Centeno C, Markle J, Dodson E, et al. Symptomatic anterior cruciate ligament tears treated with percutaneous injection of autologous bone marrow concentrate and platelet products: a non-controlled registry study.  Transl Med. 2018;16(1):246. doi: 10.1186/s12967-018-1623-3.

5.Patterson MR, Delahunt E. A diagonal landing task to assess dynamic postural stability in ACL reconstructed females. Knee. 2013;20(6):532-6. DOI: 10.1016/j.knee.2013.07.008.

6. Bączkowicz D, Skomudek A. Assessment of neuromuscular control in patients after anterior cruciate ligament reconstruction. Ortop Traumatol Rehabil. 2013;15(3):205-14.DOI: 10.5604/15093492.1058410.

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