Joint Preservation Blog

January 4, 2009

Torn Ankle Ligament

Filed under: ankle — Tags: , , , , , , , — D @ 4:49 pm
torn ankle ligament

torn ankle ligament

The outside (lateral) ankle ligaments are the ones that are usually injured. These are the anterior and posterior (front and back) talo-fibular ligaments (the duct tape that holds the talus bone to the heel bone) and the calcaneo-fibular (the duct tape that holds the outside small leg bone (fibula) to the heel bone (calcaneus)). As a physician with a torn ankle ligament, there are three ways to fix a torn ankle ligament that hasn’t healed on it’s own:

1. Tendon graft surgery. The surgeon will take a tendon from the foot and sew it into place to substitute for a torn ankle ligament. The surgeon may also sew up any partial tears in any of the ankle ligaments. There are tow big downsides. The first is that this is a tight space and getting an arthroscope into the ankle can by itself cause some tissue damage. The second is that the tendon graft may end up either causing biomechanical issues (you need all of your tendons, so borrowing one from another spot may cause problems) or it can be placed too tightly and cause further ankle arthritis.
2. Prolotherapy. This is the injection of substances to cause a brief inflammatory healing reaction in the ligaments. For more information on prolotherapy.
3. Percuteneous stem cell assisted repair. This is where the doctor takes the patients own stem cells, grows them in a lab over a few weeks to bigger numbers, and then injects them back into the torn ligaments to repair the tears. This is the future of dealing with this problem and has just become available in the US. For a vido on the subject, see below:

December 15, 2008

How to Heal a Torn Ligaments Shoulder

How to heal a torn ligaments in the shoulder.  There are many ligaments that help to support the shoulder.  Ligaments are the duct tape that hold the shoulder bones together.  These include the coraco-acromial ligaments (the duct tape that holds the collar bone to the front of the shoulder blade).  Other ligaments include the joint capsule of the AC joint (duct tape that holds the AC joint together) and the shoulder joint capsule (the duct tape that holds the shoulder ball in the socket).  An injury that injures these ligaments can cause instability, meaning that the ligaments can be stretched an lose their ability to hold the shoulder bones together as you use the shoulder.  This can cause many issues, including early arthritis and pain.  Treatment options have traditionally been surgical.  However, newer non-surgical torn shoulder ligament cures are now available. 

Surgery for this area usually means sewing the torn ligament together or back to it’s attachment to the bone.  While for a complete tear of one of these ligaments this may the only way to get the two ends back together, for partial tears, this is an older method of repair that may have more problems than benefits.  For example, sewing a partially torn ligament often over tightens the ligament.  Newer treatments are injection based.  This means that adult stem cells can be injected into the ligament to help it mend, rather than needing surgery.  The newer stem cell based treatments (links above) also mean much less down-time and immobilization for the patient.   No more blue pillow immobilizer!

As an example, a patient with an AC joint injury often has chronic and painful popping and cracking in this joint.  The shoulder muscles underneath can become sore.  The surgical option is to sew a cadaver ligament or synthetic material around the injured ligaments to try and stabilize the joint.  However, there is huge down-time, with the patient being unable to use the area for months.  In addition, over tightening is common, and this leads to more arthritis.  The newer technique of injecting stem cells into the ligament requires no or little down-time and likely results in a more physiologic repair (without the over tightening) because the goal with this procedure is to get the ligament to heal back to it’s pre-injured state (or as close to it as possible).

torn shoulder ligaments cures

There are many ligaments that help to support the shoulder.  The shoulder ligaments are the duct tape that hold the bones together.  These include the coraco-acromial ligaments (the duct tape that holds the collar bone to the front of the shoulder blade).  Other ligaments include the joint capsule of the AC joint (duct tape that holds the AC joint together) and the shoulder joint capsule (the duct tape that holds the shoulder ball in the socket).  An injury that stretches these ligaments can cause instability, meaning that the duct tape can be stretched an lose it’s ability to hold these shoulder bones together as they move and as you use the shoulder.  This can cause many problems, including early arthritis and pain.  Torn shoulder ligament cures have traditionally been surgical.  However, newer non-surgical torn shoulder ligament cures are now available. 

Surgery for this area usually means sewing the torn ligament together or back to it’s attachment to the bone.  While for a complete tear of one of these ligaments this may the only way to get the two ends back together, for partial tears, this is an older method of repair that may have more problems than benefits.  For example, sewing a partially torn ligament often over tightens the ligament.  In addition, this surgical approach carries more risk of infection.  Newer treatments are all injection based.  This means that stem cells can be injected into the ligament to help it mend, rather than needing surgery.  The newer stem cell based treatments (links above) also mean much less down-time and immobilization for the patient. 

As an example, a patient with an AC joint injury often has chronic and painful popping and cracking in this joint between the front of the should blade and the collar bone.  The shoulder muscles underneath can become sore.  The surgical option is to sew a cadaver ligament or synthetic material around the injured ligaments to try and stabilize the joint.  However, there is huge down-time, with the patient being unable to use the area for months.  In addition, over tightening is common, and this leads to more arthritis.  The newer technique of injecting stem cells into the ligament requires no or little down-time and likely results in a more physiologic repair (without the over tightening) because the goal with this procedure is to get the ligament to heal back to it’s pre-injured state (or as close to it as possible).

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