Joint Preservation Blog

January 10, 2009

basketball ankle supports

ankle brace

ankle brace

As a doctor with an ankle problem, who plays basketball, the best ankle brace I’ve found is the Malleoloc.  However, if you have an ankle problem like I did, why not get rid of the brace?  There are now new treatments where the doctor injects your own stem cells into the ankle ligament tear to heal the damage.  This way you avoid braces and surgery!  This procedure should allow you to get rid of the basketball ankle supports for good.  In this procedure, your own adult mesenchymal stem cells are isolated and then grown to larger numbers.  These healing repair cells are then injected into your torn ankle ligaments.  After this cutting edge procedure, you can wear a basketball ankle support for a few weeks, but continue playing and working out while the ligaments heal.  Maximum healing is 6-12 weeks.  You can come out of the basketball ankle supports after just a month.  Why go through all of this?  An unstable ankle eventually damages the cartilage in the ankle and leads to early arthritis.  So what’s a mild pain in the ankle now, will be big arthritis in 20 years, unless you get the ankle ligaments fixed.

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Ankle support in london?

As a physician, you might say that I have an American MD specializing in Regenerative Medicine and a “doctorate of hard knocks” in ankle braces.  When I came across people searching for “Ankle support in london” I had to throw in my two cents.  I don’t live in London, far from it, I’m in beautiful Boulder, Colorado.  If you’re looking for an ankle support brace, I can tell you first hand that I’ve tried them all.  The winner?  The Malleoloc.  However, my quest for the perfect ankle support didn’t end there, I then tried prolotherapy which allowed me to get rid of the ankle support brace.  This technique involves injecting substances into the ankle ligaments to kick off an inflammatory healing response.  This worked pretty well, even allowed me to take a run every once in a blue moon.  What would I do today instead of the ankle support?  I’d try this cutting edge procedure where they inject your won stem cells into the ankle ligaments to heal and repair the damage.  The video below shows a patient where this was done in the U.S.:

January 4, 2009

Ligament Tear Symptoms

Ligament Tear Symptoms

Ligament Tear Symptoms

What are ligament tear symptoms? Think of ligaments as the duct tape that holds your bones and joints together. What happens when the duct tape gets stretched or gets torn? In this case, the duct tape (your ligaments) don’t hold the joint together, allowing for too much movement. While the area of the ligament tear can hurt and swell, once that initial several weeks of healing is over, if the duct tape hasn’t mended completely, the joint can be left unstable (read moving around too much). This instability can cause popping, clicking, and/or further swelling and pain in the joint. Over a few months to years, this can cause arthritis to develop much more quickly. How do you fix this ligament issue? Surgery is a possibility, but a bit more traumatic than the repair needs to be in most instances. A newer method is injecting your own stem cells into the ligament to get it to heal. The ligament grades above show that grade 1 and 2 are when the ligament is stretched or partially torn, grade 3 is completely torn. This stem cell treatment works best in grades 1 and 2. If you have a grade 3 tear, then surgery may be the only answer at this point.

December 23, 2008

ACL Laxity and Knee Braces

ACL Laxity and Knee Braces.  The ACL is the inner duct tape (otherwise known as a ligament) that holds the knee together in a front-back direction.  This means that it prevents the lower shin bone (tibia) from moving forward on the thigh bone (femur). This ligament can be stretched or torn completely.  In these cases the joint is said to be “lax” and in need of either surgical repair, non-surgical repair, or knee bracing.  Bracing a knee with ACL Laxity involves stabilizing the femur and tibia in a front-back direction. However, there are pros and cons.   One of the problems is that bracing still allows some movement, which ultimately injuries the joint.  Up until now, there has been no way to repair a stretch injury to the ACL without surgery. However, the development of injection based therapy for partial ACL tears and laxity has been a big advancement beyond surgical grafts.  As an example, the Regenexx procedurenow allows doctors to inject the patient’s own stem cells onto the stretched ACL ligament and tighten that ligament back to it’s normal strength and length.  This development allows the patient to get rid of the brace all together.  Since there is no surgery needed, the recovery is much quicker and bracing is only used for a few weeks after the procedure if the laxity is severe.  This newer technique doesn’t work when there is no ACL left, but only if there are ACL fibers that can still be detected on MRI.  

As a physician who treats patients with these injuries, the best brace is the one that fits well.  For general fitting and measuring instructions, click here. Also, I often advise my patients to consider getting a slightly used brace.  Ebay can be a great place to to find a knee brace that will help with ACL laxity.

Below is a short video on the topic of repairing ligament tears by injecting your own stem cells.  While this shows an ankle ligament example, this could just as easily be a partial ACL tear.

How to save a knee…

Filed under: knee — Tags: , , , , , , , — D @ 2:14 pm

This is a case of a 72 yo male who makes fangs.  Yep, he is a professional dental prothesis maker for everyone from Hollywood actors to Goth kids who just want to add a little Dracula look to their black attire.  His knee is for all intents and purposes trashed (what we would call grade 4 Kellgren osteoarthritis).  How did we make his knee functional again, what were the steps?

First, he had significant problems with myofascial trigger points in his muscles and loose collateral ligaments (the duct tape that holds a joint together).   Before we could do anything else, we needed to solve these issues.  IMS therapy helped get rid of these muscle knots and prolotherapy injections helped tighten his knee ligaments.  The big difference here was that he felt like his knee was more stable and not “moving around” all the time while he made his fangs.  However, he still had significant pain especially with standing for a long-time.  So the next step was to look at his cartilage on an MRI.  His knee was a mess, with severe cartilage loss and meniscus loss.  While there is no way to “grow” him a new knee, we could use his own adult stem cells to help rebuild some cartilage and improve the health of what is still left.  As a result, we collected his stem cells, sent them to the lab for culture expansion (to grow to bigger numbers) and then injected those into the knee.  His pain with standing went from about a 7/10 to a 4/10.  While this was significant, his MRI provided a clue to another issue.  Because he was unable to fully extend the knee (due to his severe arthritis related bone destruction through the years), he was standing by stressing his quadiceps and patellar tendon (the tendon that holds the knee cap and attaches below the front of the knee).  This happens in some patients who have this lack of knee extension (can’t get their knee stright) because straightening the knee allows us to use no energy when we stand.  When you can’t “take the weight off” by fully extending the knee you hand on the quadiceps muscle and it’s patellar tendon.  As a result, his patellar tendon was constantly getting overstressed.  To help this we injected this area to attract stem cells to help beef up the tendon.  This finally helped the rest of his pain and allowed him to stand longer while making his fangs.

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