Stem Cell Injection For Achilles Tendinitis Offers Alternative Treatment Option
By Dr. Michael Kokat
Achilles tendinitis is a common ailment we see in athletes and the general public here at Advanced Foot & Ankle of Wisconsin. Oftentimes, the acute aspect of Achilles tendinitis is treated with immobilization, physical therapy, ultrasound and anti-inflammatory or steroidal medications and we can see a quick reduction in acute tendon issues. Sometimes the condition is present for months if not years and becomes harder to treat. Oftentimes, patients do not want surgical intervention and they are looking for alternate forms of treatment.
The Achilles tendon itself cannot be injected with corticosteroid because this will cause a rupture and will inevitably lead to surgical intervention. However, there are new therapies and treatments available to us that allow us to do modified injection therapy. These type of injections can be done under moderate sedation where you are breathing on your own and it is safe, almost like a twilight. These injections feature stem-cell-type therapies, whether it be fetal stem cells or stem cells from your own blood or both, which are harvested and then reinjected into the Achilles tendon under ultrasound guidance in a needling-type format. This type of treatment works exceptionally well. The success rate is 75% or greater. However, the downfall of this procedure is it does not cure the condition. Oftentimes, patients will have to come back on a yearly basis for injections.
The most common type of stem cell utilized for the Achilles tendon is platelet-derived plasma which is derived from the patient through their own blood. The blood is taken, spun down and separated into the different elements. The platelet-rich plasma is usually about 4 mL of the 10 mL that we collect and is clear, gold liquid. These type of platelets help stimulate regrowth and regeneration of chronically damaged tissue we see in Achilles tendinosis. It also decreases inflammation as platelets are known to do so in the area, thereby managing and decreasing pain associated with the chronic condition. If stem cell therapy fails and the patient proceeds to surgical intervention, there are minimally invasive procedures we can do such as a gastroc lengthening through a scope which requires one or two stitches or a percutaneous Achilles tendon lengthening which again requires one or two stitches.