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Muscle, Tendon, Ligament & Cartilage Tears

Macquarie Stem Cells has provided the information below so consumers can understand the services we provide. We don’t aim to encourage consumers to seek out such treatments prior to an assessment by a health professional to determine your suitability for treatment.  We aim to provide you with an unbiased range of treatments that are available aside from biological therapy, this is discussed in ‘supporting information>other-options’  page on our website.

Tears Can Occur due to Osteoarthritis Degeneration.

Tears, yes they can occur due to a high impact injury. However, it can be extremely common for individuals with osteoarthritis to have weakened supporting structures around their joints. The root cause of this is inactivity and/or lack of proper movement. Macquarie Stem Cells understands, arthritis pain is difficult to deal with, so you may end up moving differently to avoid pain, or you may even avoid activity/movements all together. Unfortunately this only speeds up the process of degeneration, over time it will lead to inflexibility and weaken the muscles, tendons, ligaments supporting your joint. This can lead to minor (partial) or complete tears of these tissues.

 

Muscle & Tendon Tears

Muscle Tear

A muscle tear can also be referred as a muscle strain, or pulled muscle (depending on the severity of the tear). This occurs when your muscle is overstretched or torn. This usually occurs as a result of fatigue, overuse, or improper use of a muscle. Strains can happen in any muscle, but they’re most common in your lower back, neck, shoulder, and hamstring. (Epainassist, 2017)

Tendon Tear (pictured right)

A tendon tear is very similar to a muscle tear, however tendon’s will take a very long time to repair and their symptoms can be significantly more debilitating when compared to a muscle tear. Strong muscles can pull on tendons, during this process it can either cause the tendon to rupture or become inflamed. The stage of inflammation within the tendon is called “Tendonitis” or “Tendinosis”. Chronic degenerative tears are most common in the elderly. (Tornero-Esteban et al., 2015)

 

 

Ligament & Cartilage Tears

Ligament Tear

A ligament is a short band of tough, flexible tissue, made up of lots of individual fibres, which connect the bones of the body together. Ligaments can be found connecting most of the bones in the body.

Ligaments are strained when the joint is stressed beyond its normal range. Common causes of a ligament injury include twisting or landing awkwardly.  The knee and ankle joints are extremely vulnerable and common for tears. (Physioworks, 2017)

Cartilage (pictured left)

The cartilage is the firm, flexible connective tissue found in between the bones, the purpose of the cartilage is to protect and cushion your joint movements. Over time, cartilage can become fraile due to the process of degeneration known as osteoarthritis. This fraile cartilage can tear easily. Tears to the cartilage can be located in many different shapes and sizes. They can also occur due to injury. (Physioworks, 2017)

All soft tissue tears share a common element, tears can occur in any joint of your body and it can be due to either a;

  1. Traumatic tear, this is self-explanatory, it occurs due to trauma or an injury.
  2. Degenerative tear, these types of tears are most unexpected. They occur because the structure becomes weak and it eventually tears due to the process of aging. (Physioworks, 2017)

The Biological Treatment of Tears

After Macquarie Stem Cells performs the biological treatment to the damaged or torn tissues, the repair process is able to kick start. 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.

Our Biological Treatment.

The principals of treating osteoarthritis come into play, even though you have a tear, inflammation is a key feature of the early period following tendon repair, but excessive inflammation destroys tissues. By controlling the inflammatory environment using biological treatments, we can enhance the healing process.

  • We can use your body to target and fight off inflammation. Inflammation that was causing you pain will reduce or resolve completely, therefore giving you back quality of life.
  • When your blood vessels are no longer inflamed. Nutrient delivery resumes as it always should have.
  • With proper nutrient delivery, the torn tissue is able to receive all of the required nutrients to carry out repairs.
  • Our biological treatment can also directly assist in repairing tears with matching tissue type through what is called ‘the process of cell differentiation’.
  • Nerve pain can be associated with certain types of tears, this is due to your nerves being inflamed due to damage. As a part of the healing process, we aim to resolve inflammation surrounding the nerves, this can dramatically improve the odd sensations you are feeling such as burning, tingling, shooting pains and more. (Nerve pain is discussed in further detail on this page.)

Studies have shown biological treatments for tissue defects such as tendons, cartilage and ligaments can be safe and effective. The treatment has shown an increase to the tendon’s maximum load capacity over time.

(Paz Rodriguez et al., 2012) (Wu et al., 2013) (Gibbs et al., 2015) (Jo et al., 2014)(Michalek, 2015) (Manning et al., 2015)(Tornero-Esteban et al., 2015)

Treating 3 categories of tears

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 biological treatments 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 or current Tears

If the tear is fresh (within the first 1 to 3 months) the biological treatment can resolve the inflammation as mentioned previously, from this point the treatment has the potential to repair the damaged tissue type with the same tissue, NOT SCAR TISSUE.  This means your body’s attempt to repair the damage with scar tissue will be over ridden. Therefore, the treatment has the ability to restore the tear back to full function and original form. 

3. Complete tears or full detachment

There is not enough evidence to suggest biological treatments 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 is necessary to re-join the tear back to one piece. However, a biological treatment can speed up the rate of recovery significantly, with more functioning tissue as opposed to scar tissue.

Repairs without biological treatment

Muscles

Muscles are one of the simplest bodies of tissue in your body to be repaired, this is due to the muscle containing many fibrous bands that are easily accessible with blood. The nutrient delivery to the source of damage is rich. Depending on the extent of the tear, further interventions may be required but in many cases the repairs are successful.

Tendons

Tendons lack blood supply, it’s almost as if there is a large filter blocking the nutrient delivery. They require lengthy periods of rehabilitation, especially in elderly patients. Large tears have shown to increase in size and muscle weakness surrounding the tendons appear to exacerbate the process.  Steroidal injections have shown to have a direct deterioration effect on tendon tissues, they have been widely used for short term pain reduction but they increase the risk of rupture. Existing medical and surgical treatments often fail to regain full tendon function.
(Wong et al., 2004), (Pak J. et al., 2017) (Wu, Nerlich and Docheva, 2017),(Moosmayer, Gärtner and Tariq, 2017)

Ligaments

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 body to induce healing. In many cases these areas may require surgical intervention. (Kamimura and Kimura, 2014)

Cartilage

Cartilage tears are in their own category since they can be 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. Current treatments for cartilage tears are addressed by surgical interventions if the symptoms are unbearable. (Solomon et al., 2005) 

Further Published Review

Dr. Jaewoo Pak has published a complete literature review observing over 1500 patients whom have been treated with biological interventions for osteoarthritis including tears to tissues. This publication provides great insight to the outcomes post treatment for specific issues such as;

  • Tendinopathy/Tendonitis
  • Meniscal Tears
  • Bone Damage
  • Epicondylosis
  • Avascular Necrosis

We would be more than happy to provide this educational piece to you, please just ask us.

 

TO OBTAIN FURTHER INFORMATION

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Remember, any surgical or invasive procedure carries risks.Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.