Imagine suffering a debilitating injury and facing the prospect of complex reconstructive surgery, only to find an alternative that could see you returning to recreational sports in just four months.
This is the highly encouraging outcome of a recent prospective study that explored using mesenchymal stem cells (MSCs) as a potential alternative to surgery for chronic Achilles tendon ruptures.
Key details
- Chronic ruptures: Primarily caused by misdiagnosing acute Achilles injuries.
- The challenge: Chronic ruptures typically require complex reconstructive surgery, which involves a lengthy recovery period, a high risk of complications, and carries no guarantee to fully restore function.
- A regenerative alternative: A recent study explored using mesenchymal stem cells (MSCs) as an alternative to surgery for six patients with chronic ruptures.
- Promising outcomes: Patients experienced significantly reduced pain by three months and were able to return to recreational sports by four months. After 24 months, MRIs showed complete, safe tendon regeneration with no re-ruptures.
- Further trials required: While larger-scale trials are required before this could become a standard clinical treatment, these highly encouraging results showcase the tremendous regenerative potential of stem cells.
What is a chronic Achilles tendon rupture?
The Achilles tendon is the largest tendon in the human body, connecting the muscles in the back of the calf to the heel bone. The tendon helps to bend the foot downwards, allowing us to stand on tiptoes as well as pushing forward when walking or running.
Like all muscles and tendons in the body, if too much force or strain is placed on the tendon too suddenly, it can tear or snap. This can happen in activities that involve lunging motion, like tennis or football, but may also occur if the foot is suddenly forced into an upward-pointing position by a slip or fall.
Rupture of the Achilles tendon is a common injury in athletes of all skill levels, from professional and semi-professional to recreational. It occurs most often between the ages of 30 and 50, and affects about 1 in 15,000 people at any given time, although the figure increases to approximately 1 in 8,000 in competitive athletes.[1]
Early diagnosis of the rupture is essential for successful treatment and restoration of the tendon, but over 20% of acute injuries are misdiagnosed, leading to a chronic rupture. Treatment of a chronic rupture becomes vastly more complicated and demanding, as simple repair – reconnecting the two ends of the tendon and stitching them back together – is not generally possible,[2] as direct repair requires only a small gap (less than 2cm) between the two tendon ends.[3] Instead, reconstructive options are required. These vary depending on the age of the injury and size of the gap between the two ends of the tendon, and range from surgical tendon lengthening procedures to transferring a tendon from elsewhere in the body, either alone or combined with a lengthening procedure.[2][3]
Unfortunately, however, these procedures involve long a long recovery and rehabilitation period and have a relatively high risk of complications, including wound problems, infection, and even recurrence of the rupture. Even if the procedure is successful, a full return to sporting activity may not be possible if the repair can only provide reduced function compared to a healthy Achilles tendon.[2][4]
How could stem cells help with chronic Achilles tendon rupture?
Recently-published results from a prospective study indicate that mesenchymal stem cells (MSCs) may be able to serve as an alternative to surgical repair of chronic Achilles tendon rupture.
The study was conducted at the Institut de Teràpia Regenerativa Tissular (ITRT) in Barcelona, Spain, on a compassionate use basis, and involved six patients with a chronic Achilles tendon rupture, all male, ranging in age between 46-85, with the median time elapsed since the initial injury being 39 months (12 months to 10 years). Four of the patients had a partial rupture, and two a complete one; all had previously undergone conservative or surgical treatment for the injury.
Researchers collected bone marrow MSCs from the hip of each patient and then multiplied them in the lab until they had enough stem cells. The full dose of cells was then injected directly into the affected Achilles tendon.
Patients were allowed to return to their normal daily activities immediately; standard progressive rehabilitation therapy was provided, and patients were followed for a period of 24 months.
By three months after treatment, patients reported a significant reduction in pain; they were able to resume recreational sports by four months after treatment, and by the end of the study period, all showed complete regeneration of the Achilles tendon on MRI scans. The treatment also proved to be safe, with no serious adverse events reported; there were also no re-ruptures of the tendon during the study period.[4]
What's next for this treatment?
While these results are very encouraging, the researchers acknowledge that this was a small, early-stage study. Larger-scale, randomised trials with a control group are required to fully assess the potential of the treatment before it could become standard of care.
Even so, studies like these highlight the tremendous regenerative potential of stem cells. It is this potential that makes securing your baby’s stem cells at birth such a forward-thinking investment. To learn more about these powerful cells, and how you could preserve a rich source of them for your baby’s potential future use, fill in the form below to request your free guide to cord blood banking.
References
FIND OUT MORE, REQUEST YOUR WELCOME PACK TODAY
All you need to know to make an informed decision.
Provide your contact details to request:
- Complete Welcome Pack and Parent’s Guide
- Information via email
- Contact from our specialist advisors
