November 10, 2022
Traditional Treatment Paths
Traditional treatment for orthopedic problems (specifically foot and ankle) usually consists of non-operative treatment. If this fails, we then will consider possible surgical intervention. Non-operative treatment has been largely based upon physical therapy and short-term immobilization whereas brace application would be used for long-term treatment. In some cases, it may be appropriate to have a cortisone injection, which is a steroid injection for pain relief and inflammation control. Specifically in foot and ankle injuries, there’s a multitude of inserts, braces, or devices that can potentially help the patient in an effort to avoid surgery and try to utilize the body’s natural healing process. People seeking alternatives to traditional methods of treatment may look at regenerative medicine.
What is Regenerative Medicine?
Regenerative Medicine is the idea that you can use your body’s natural biological milu to improve upon a chronic problem that won’t heal or continues to cause pain. Sometimes patients are left with chronic pain, which is where Regenerative Medicine comes in. As this occurs, Regenerative Medicine uses the body’s natural ability to heal by trying to recreate the ability for the body to focus on that chronic ailment and try to heal it. Orthopedics tries to introduce new methods of healing to that focal area of pain or injury. This would include a stem cell or PRP (platelet rich plasma) injection. These injections come from the body’s peripheral blood where the patient gets their blood drawn. Once the blood is drawn it is centrifuged under specific criteria. The blood is then separated and the centrifuged is allowed to concentrate specific products in the blood. We know from biological medicine that there are various growth factors in the blood that live on these platelets. Concentrate is then placed in a syringe and injected to an area of concern to try to develop some response. Resulting in a more aggressive and responsive healing in the body. The essence of regenerative medicine is trying to stir up the immune system so that it can start. Some people may also refer to this as stem cell medicine, which is drawing fluid from the bone marrow (where stem cells naturally come from). Although this hasn’t been proven, the idea that there’s a potential growth factor from bone marrow is often used instead of peripheral blood.
What are some common injuries we use this for?
For foot and ankle injuries, PRP injections are commonly used. For example, this can include ankle arthritis, plantar fasciitis, Achilles & tendon issues, and other tendon problems that do not seem to improve.
Typically, a patient will undergo an initial, more standard non-surgical treatment. If this fails, an alternative treatment (like regenerative medicine) can be offered as an option to try to avoid surgery. The protocol depends upon the injection. Most often, the patient is meant to refrain from many anti-inflammatories, aspirin, cortisone, and steroid injections. The injection will be performed at the office taking about half an hour because the centrifuge takes time to concentrate the blood. After the injection, the patient typically goes to immobilization in the form of a boot in order to protect the lower extremity after the injection is performed. This would be accompanied by physical therapy to start rehabilitation.
Full effects can take up to several weeks and months to occur. There can be successive injections if initial improvement is partial. However, there is no guarantee that it can work. In addition, current research is limited in some of these. This method of treatment has minimal risks and can remove the need for surgery.
If you believe you may be experiencing a cartilage injury or know someone he may, Dr. Miller is Beacon Orthopedics’ foot and ankle specialist and is available at several locations around the Cincinnati area. Contact us today for more information! Click here to learn more and schedule an appointment with Dr. Miller for foot and ankle injuries.