Int Orthop. 2015 May;39(5):901-5. doi: 10.1007/s00264-015-2725-7. Epub 2015 Mar 22.
Outcomes of acute Achilles tendon rupture repair with bone marrow aspirate concentrate (BMAC) augmentation
Stein BE, Stroh DA, Schon LC.
“Excellent results, including no re-ruptures and early mobilisation, were observed…”
Optimal treatment of acute Achilles tendon ruptures remains controversial. Positive results using stem-cell-bearing concentrates have been reported with other soft-tissue repairs, but no studies exist on outcomes of bone marrow aspirate concentrate (BMAC) augmentation in primary Achilles tendon repair.
We reviewed patients with sport-related Achilles tendon ruptures treated via open repair augmented with BMAC injection from 2009 to 2011. Data on operative complications, strength, range of motion, rerupture, calf circumference and functional improvement through progressive return to sport and the Achilles tendon Total Rupture Score (ATRS) were analysed.
A total of 27 patients (28 tendons) treated with open repair and BMAC injection were identified (mean age 38.3 ± 9.6 years). At mean follow-up of 29.7 ± 6.1 months, there were no reruptures. Walking without a boot was at 1.8 ± 0.7 months, participation in light activity was at 3.4 ± 1.8 months and 92% (25 of 27) of patients returned to their sport at 5.9 ± 1.8 months. Mean ATRS at final follow-up was 91 (range 72-100) points. One case of superficial wound dehiscence healed with local wound care. No soft-tissue masses, bone formation or tumors were observed in the operative extremity.
Excellent results, including no re-ruptures and early mobilisation, were observed in this small cohort with open Achilles tendon repair augmented by BMAC. No adverse outcomes of biologic treatment were observed with this protocol. The efficacy of BMAC in the operative repair of acute Achilles tendon ruptures warrants further study.
LEVEL OF EVIDENCE:
IV – Therapeutic.
Ruptured Achilles Tendon Treatment at Dr. Riordan’s Clinic in Dallas-Fort Worth
At Riordan-McKenna Institute, Dr. McKenna performs a procedure for achilles tendon rupture that is similar to the one described in this study. However, Dr. McKenna augments the BMAC injection with AlphaGEMS amniotic tissue product. AlphaGEMS is a pliable tissue allograft (transplant) derived from human placental amnion, which contains over 100 growth factors and functions as a biologic structural matrix to facilitate and enhance tissue healing and repair. The inclusion of AlphaGEMS adds a new dimension to the tissue repair process.
For more information about BMAC and AlphaGEMS treatment at RMI, please visit: http://www.rmiclinic.com/non-surgical-stem-cell-injections-joint-pain/stemnexa-protocol/
If you have suffered a ruptured achilles tendon and would like to be evaluated for treatment at RMI, the first step is to complete an online medical history. Once we receive it, our staff will contact you to answer general questions and to guide you through the rest of the evaluation process, which usually requires recent MRI images and an MRI report.