Treating Tears of Cartilage & Ligaments
This blog we will discuss tears and how your body naturally will address a torn cartilage or tendon in comparison to how this would change with the use of Stem Cells.
First Lets have a look at how our body naturally addresses tears to tissues.
Nutrient delivery is the key to repairing any form of damage in your body; nutrients as well as your natural repairing stem cells are released and carried in your blood. Therefore blood delivery to the area of damage is extremely important.
How your body addresses Muscle & Tendon tears:
Muscles have a very good blood supply; they are often able to be repaired by your body quickly and efficiently. It is rare for a muscle tear to require surgical intervention, unless the tear is significant.
Tendons are another concern, they have poor blood supply. When the tendon gets damaged or torn they will become inflamed and it will naturally take a few months up to 2 years for these issues to resolve. Injections such as platelet rich plasma (which we can provide here) will be able to speed up the recovery/repair process.
How your body addresses Ligament tears:
The ligaments can be difficult to repair; this is typically due to the poor blood supply to the ligament. There are sections in the distal part of ligaments which are vascularized by branches of the surrounding arteries. In other sections of the ligament there are avascular zones. These are areas which have no blood supply. (Petersen and Tillmann, 1999)
When the tear is located within an avascular area, it is difficult for your immune response alone to induce healing. In many cases these areas may require surgical intervention. (Kamimura and Kimura, 2014)
How your body addresses Cartilage tears:
Cartilage tears are in their own category since most parts of the cartilage is completely avascular. There is no blood flow or nerve connection to the actual cartilage. For this reason alone, cartilage does not possess the regenerative capacity of bone or the other connective tissue types. (Solomon et al., 2005)
A tear of cartilage will require surgical intervention if the symptoms are unbearable.
Types of Cartilage Tears
Below is a typical example of a meniscal tear of the knee.
HOW DO STEM CELLS WORK TO TREAT THESE TEARS?
When it comes to treating patients with a tear of any kind, the symptoms are the initial target which show improvements. This specifically relates to the level of pain, stiffness and strength you have lost in your joint which is causing you to struggle with your daily activities.
The stem cells have the potential to;
- Target and fight off inflammation (reduce the pain you have)
- Differentiate to the matching tissue type (eg: muscle, tendon, ligament & cartilage)
- Increase the productivity of synovial fluid (increase lubrication of your joints)
- Soften existing scar tissue (increase range of movement)
(Wu et al., 2013) (Gibbs et al., 2015) (Jo et al., 2014) , (Michalek, 2015), (Condé-Green et al., 2016)
There are 3 categories when it comes to treating tears with stem cells.
1. Pre-existing or old tears which have been partially repaired.
If the tear is pre-existing, your body would have attempted to repair the area. This will be repaired with scar tissue.
Scar tissue is able to hold the tissue together but it is inflexible and weak. This means the area can either easily re-tear or the surrounding tissue adjacent to the existing tear can sustain a new tear.
The cells can soften existing scar tissue which in-turn means better elasticity, improved range of motion and this area will be less likely to re-tear.
This will allow the patient to be able to take on physiotherapy to increase the range of motion and strength surrounding the tear.
NOTE: This does not apply to cartilage tears since they can’t form scar tissue.
2. New & current tears which are still attached (Partial Tears)
If the tear is fresh (within the first 1 to 3 months) the cells will be able resolve the inflammation as mentioned above, from this point they will continue to differentiate into the existing tissue type.
This means your body’s attempt to repair the damage with scar tissue will be over ridden with the ability of these cells to repair the damage with the original of tissue.
For example, stem cells will differentiate into tendon cells; these tendons cells will repair the torn tendon as opposed to forming scar tissue. Therefore the treatment has the ability to restore the tear back to full function and original form.
3. Patients with complete tears or full detachment
This is a different area where there is not enough evidence to suggest stem cells alone will completely repair the tear. We have observed anecodotal cases in both our own practice as well as international seminars where complete detached ligaments and cartilage tears have been restored back to full-function. However current medicine suggests a surgical intervention to re-join the tear back to 1 piece.
Stem cell treatment has the potential to improve recovery rate post surgery and have a significantly higher chance to restore full-function.
RESULTS POST TREATMENT
Anterior Cruciate Ligament (ACL) Tear of the knee – MRI
(Pitts et al., 2015)
Partial Tear in the Labrum of a shoulder – Fully Healed
(Macquarie Stem Cells , 2016)
Do you also suffer from Osteoarthritis?
It is very common for patients who have tears in their joints to also suffer from mild to severe osteoarthritis. Osteoarthritis has shown extremely good results by the treatment of Stem Cells, find out more here “Treating Osteoarthritis with Stem Cells”
List of references can be found in the References section of our website.