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Muscle, Tendon, Ligament & Cartilage Tears

Macquarie Stem Cells has provided this information to educate the public based on peer reviewed, published scientific and medical documents. 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. 

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 muscle 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”

Despite the great advances in the surgical procedures used to treat rotator cuff tears, the frequency of re-rupture is still unacceptable for large injuries. Chronic degenerative lesions 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.

There are two distinct types of cartilage tears that can occur in the knee – a traumatic tear, and a degenerative tear. Traumatic tear is self explanatory, it occurs due to trauma or an accident. The degenerative tear is most unexpected, this occurs because your cartilage is already wearing thin, the structure is weak and it eventually tears due to the process of aging. (Physioworks, 2017)

Addressing Tears – without biological treatments

Muscles Repairs

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.

Tendon Repairs

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 Repairs

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 Repairs

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) 

 

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.

THIS IS WHERE OUR BIOLOGICAL TREATMENT STARTS.

Then, 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 has been associated with poor clinical outcomes. By controlling the inflammatory environment using biological treatments, we can enhance the healing process.

  • We can use your body to target and fight off the inflammation that is causing you pain.
  • Your blood vessels, no longer inflamed. Nutrient delivery resumes as it always should have.
  • Nerve pain can be associated heavily with certain types of tears, this is due to the inflammation surrounding the nerves. We expect this to resolve as a part of the healing process.

Studies have shown biological treatments into tissue defects such as tendons can be safe and effective. The treatment has increased 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)

 

Treatment of tears, there are 2 categories of patients

1. Patients with minor, & partial tears or tears which are still intact

  • a) 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.

  • b) 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. 

2. Patients with 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.

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

Please read all of this information on this page.

 

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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.