We can write post after post telling you all about the conditions we treat at the Centeno-Schultz Clinic, but to best understand what we do in interventional orthopedics, it’s helpful to actually watch a treatment in progress. Today, we’re bringing you inside a procedure suite with Dr. Pitts as he treats a young athlete’s meniscus tear using advanced image-guided injections in an interventional orthopedic stem cell meniscus treatment. This patient also had a history of ACL reconstructions in which portions of the hamstrings and patella tendons were excised to rebuild the ACL. Dr. Pitts treats these tendon defects as well.
Watch the video to see Dr. Pitts demonstrate step by step as he performs the procedure. The terminology used in the video is defined below.
Terminology for the Meniscus Procedure
The terminology used in the video is defined below in the order in which Dr. Pitts uses it.
- Meniscus: The meniscus is shock-absorbing tissue in the knee joint. It sits between the femur (upper leg bone) and tibia (lower-leg bone) and provides cushioning for the protective cartilage. The medial meniscus is located on the inner side of the knee. The meniscus can tear from trauma or normal wear with aging.
- MCL: The medial collateral ligament, or MCL lives on the inner side of the knee. It connects at the upper end to the femur and at the lower end to the tibia. It protects and limits sideways movement.
- Ropivacaine, Lidocaine, Marcaine: These are anesthetics. They can block nerve signals to an area so a procedure can be performed there. Lidocaine, marcaine, and some other anesthetics are toxic to any stem cells they come into contact with; therefore, Dr. Pitts uses ropivacaine.
- Coronary Ligament: The leg bones are attached to the meniscus via the small coronary ligament, which aids with stabilization. If this ligament loosens or becomes damaged, this can cause the meniscus to shift and create instability.
- Fluoroscopy: This is a real-time X-ray, and you can watch along as Dr. Pitts uses fluoroscopy to guide his needle precisely into the structures he is treating.
- Contrast: The materials injected are invisible on the X-ray, but it’s important to visualize their precise location when injected. Contrast dye provides this ability to confirm the desired location is reached. The video shows contrast flowing along the meniscus on the fluoroscopy imaging.
- Bone Marrow Concentrate (BMC): When bone marrow is drawn, this is bone marrow aspirate (BMA). The BMA is centrifuged, concentrating the bone marrow stem cells. This concentration of stem cells is bone marrow concentrate, or BMC.
- Adipose Tissue: Dr. Pitts uses adipose (fat) tissue for this treatment to help with repair and structural support.
- Patella Tendon: Attaching the tibia (lower leg bone) to the patella (the kneecap), the patella tendon is typically a strong tendon. This one, however, had a defect that weakened it due to the patient’s history of an ACL reconstruction.
Why an Interventional Orthopedic Stem Cell Meniscus Treatment Is Very Different
The typical surgical orthopedics approach to this meniscus tear would have been to go in and cut out the torn piece of the patient’s meniscus. Interventional orthopedics provides same-day treatments that are much less invasive. So before you sign on for surgical meniscus repair or any other orthopedic surgery, check with your interventional orthopedic physician (who must be IOF certified through the Interventional Orthopedics Foundation—as all of the Centeno-Schultz Clinic physicians are) first as all but the most extreme musculoskeletal conditions can be treated without surgery. As Dr. Pitts demonstrates in the video of this interventional orthopedic stem cell meniscus treatment, injecting a torn meniscus requires significantly more than simply blindly sticking a needle in the knee.