Stem Cells Therapies for Foot and Ankle Injuries

Injuries to the foot and ankle are some of the most common issues for the general population and especially for athletes. The anatomical intricacy of this part of the body, including a more limited blood flow and a much more complex range of motion than any other area in the body, can make treatment extremely challenging. In addition, since the foot is basically the foundation of the lower kinetic chain, anything that happens to the foot or ankle has the potential to affect a part or multiple parts of the body higher up the chain.

When you look at that chain, toes to foot to ankle to knee to hip to pelvis to spine to shoulders to neck, it’s clear that injuries that don’t heal properly can be much more impactful than simply being a painful issue that limits movement of the foot and/or ankle. An unstable ankle, one of the signs that a seemingly simple injury is worse than previously expected, means that the patient can’t rely on that ankle and that, potentially worse, up the line there could be knee or hip or even back issues.

Foot and ankle injuries can result in damaged connective tissue, inflammation, hypermobility, reduced mobility, temporary or chronic pain.

Foot and ankle injuries include:

  • Ligament sprain and tearing
  • Instability from ankle sprain
  • Lack of mobility
  • Cartilage fractures
  • Plantar fasciitis
  • Torn tendons
  • Achilles tendon damage
  • Slow healing fractures
  • Ligament tear or strain
  • Osteoarthritis
  • Peroneal nerve injury
  • Peroneal tendon sprain/tear

Initially, conservative treatment may be the “cure,” and can include NSAIDS, splinting, orthotics, staying off the injured area, and physical therapy. If conservative treatment fails, and symptoms persist, surgical intervention may be required. Even after successful surgery, however, these procedures often result in reduced joint mobility or compromised tendon or ligament strength.

The treatment of Foot and Ankle Osteoarthritis (OAO) is a case in point. Osteoarthritis is a breaking down of a joint’s cartilage. Though sometimes referred to as a noninflammatory arthritis, inflammation can still be a result due to wear and tear.  Total ankle replacement is often prescribed as the only real cure but there are a number of studies that illustrate how often it is necessary to perform secondary surgery to attempt to “fix the fix” of an ankle replacement. Sometimes the only option is to completely remove the hardware and instead perform an ankle fusion.

Multiple types of problems can occur: components of the hardware can loosen, infection can set in, bone fractures occur due to compromise of areas where hardware is attached. New injuries can occur in parts of the foot that were previously healthy.  These include damage caused by pins inserted into previously healthy Achilles tendons, as well as other nerves and tendons in the back of the foot and ankle. In fact, total ankle replacement is considered the best option for end-stage, bone-on-bone grinding of the joint surfaces, the sad hallmark of Ankle Osteoarthritis, but is no longer recommended as a routine solution due to the potential for complications. There are a number of studies that support the use of stem cell medicine for Ankle osteoarthritis, as the first treatment. When it is determined that surgery is the only option, there is research to support the use of stem cell injections to assist the repair work performed during surgery and to aid healing.

Stem cell medicine promotes angiogenesis (the development of new blood vessels) which helps to bring needed nutrients to the site of injury. In addition, it has antimicrobial, anti-adhesive, and anti-inflammatory properties, and because of these attributes, is rapidly becoming a proven success in the treatment of many lower extremity injuries (as well as injuries and issues throughout the body). Stem cell treatments provide excellent immunomodulatory features (the ability to control the catabolic joint environment) as well as regenerative osteochondral characteristics (the ability to heal bone or cartilage defects) which are part of the mechanism of regeneration inherent to stem cell treatments.

Historically, there are clinical reports from as long ago as the 1920’s describing the use of the earliest form of stem cell treatments, amniotic membranes, which were successfully applied to a large number of medical issues. Corneal surgery, plastic surgery, including burns and wound healing, foot and ankle issues, spine repair, nerve healing, tendon repair, all were documented. Amniotic membranes were even used in general surgery.

In patients with acute tendon or musculoskeletal injuries of the foot and ankle, including posterior tibialis tendonitis, Achilles tendonitis, flexor hallucis tendonitis and anterior tendonitis, the use of injectable allograft shows excellent efficacy in reduction of pain and inflammation within six weeks of injection. In general, tendons have little chance to heal due to low blood supply, much like cartilage in people with arthritis.  Stem cell treatments are changing that. In fact, within three weeks of injection, 9 of the 10 patients in one study of acute or chronic tendonitis, had a 75% improvement in pain levels.  An added bonus is that stem cell therapy, due to its rapid results, shows promise in the ability to keep patients dedicated to the treatment regimen more than standard tendon injury treatment techniques.

As the age of the population of the US increases, the need for regenerative medicine treatments will only increase as well. There is already a growing interest in minimally invasive treatments that can replace or at least delay the need for surgery; in addition, there are stem cell treatments that may be able to mitigate or even cure injuries and diseases that were once considered permanent. With growing numbers of more active older adults, the need for these types of therapies will be in even greater demand to improve the outcomes of patients who will aim for a quicker return to activities without the need for lengthy downtime.

To keep up with demands of this rapidly growing medical field, Ariel Med Distribution offers their Bioactive Regenerative Fluid, one of the few injectable stem cell allograft medicines that has received FDA approval for its IND (Independent New Drug) application. This is the gold standard of quality and safety in what has, up to now, been something of a free-for-all market.  Now doctors and their clinics can confidently put aside invasive treatments and surgeries, even if temporarily, and try natural, effective stem cell therapy.