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Regenerative Medicine

What is Orthobiologic Treatment for Achilles Injury?

Orthobiologic treatment for Achilles injury is the use of orthobiologics in the treatment of an Achilles injury.

Orthobiologics are natural substances such as cells, blood components, and growth factors that are typically used to speed up the healing of damaged tissues such as bones, muscles, tendons, and ligaments. Orthobiologics may be obtained from your own body or a donor and are usually administered in the form of injections. They can be used in the treatment of many orthopedic conditions including Achilles injury.

Types of Orthobiologics

There are three main types of orthobiologics:

  • Cell therapy: These are a concentration of specialized cells derived from the bone marrow or abdominal fat of the body. They can differentiate into other cell types to regenerate tissue. 
  • PRP (Platelet Rich Plasma): PRP is derived from your blood which is drawn, collected, and spun at high speeds in a centrifuge machine to separate out the platelets and plasma components. 
  • Matrix (conductive materials): These are natural bone grafts obtained from the patient or a donor that functions as a medium in which new bone grows. It is used when there is a gap as a result of significant bone loss. 

Of all the types, cell therapy has the greatest potential for promoting healing. This therapy is increasingly being used in the treatment of orthopedic injuries and conditions and may be considered as an alternative to surgery.

Significance of Orthobiologics

Your body can repair most injuries by itself. However, with severe injuries or with advancing age, your body’s repair process may find it difficult to keep up with the damage done.

Specialized cells are present in all of us that act as a repair system for the body. The purpose of cell therapy is to make use of these cells to aid in the natural regeneration of the injured or damaged tissues such as bone, muscle, or tendon. 

When these cells are injected into your injured Achilles, they begin to divide, grow, and subsequently develop into the kind of cells needed for repair thus accelerating the healing process.

Anatomy

The Achilles tendon is a strong fibrous cord or group of tough fibrous tissue present behind the ankle that connects the calf muscles to the heel bone. It is used when you walk, run and jump. When the Achilles tendon becomes thin, weak, or if it is not used, it may be susceptible to injury or damage.

An Achilles injury is defined as damage or rupture of the Achilles tendon due to physical trauma. The rupture occurs most often in middle-aged athletes participating in sports that involve running, pivoting, and jumping. Recreational sports that may cause an Achilles tendon injury include tennis, racquetball, basketball, soccer, and badminton.

Indications for Orthobiologic Treatments for Achilles Injury

Your physician may recommend orthobiologic treatment for Achilles injury if you have experienced an Achilles tendon rupture or damage and conservative treatment measures such as rest, medications, and physical therapy have failed to relieve symptoms, such as:

  • Swelling and bruising
  • Mild or severe pain
  • Stiffness
  • Loss of strength
  • Decreased movement of the ankle
  • Muscle weakness or tenderness
  • Difficulty in walking or standing

Procedure for Orthobiologic Treatments for Achilles Injury

The procedure begins with your doctor extracting specialized cells from your body. There are many sources of these specialized cells in your body. The most important source is bone marrow located in the center of long bones and the pelvic bones from where they are usually derived as this region has the highest concentration of these cells. However, these cells may also be harvested from natural fat deposits in your body such as the abdomen. Your doctor will choose the right source depending on your requirement and condition.

The procedure usually takes about half an hour depending on several factors. It is performed under local anesthesia. A highly sophisticated ultrasound instrument with enhanced needle visualization is used for the precise delivery of these cells. 

During the procedure:

  • The area from where the cells are to be harvested is cleaned and numbed.
  • Using a special needle and syringe, fluid containing the cells is drawn from the source. 
  • The fluid obtained is then spun in a centrifuge machine for 10 to 15 minutes.
  • This process helps obtain a concentrated layer of the specialized cells to be used. 
  • The injured Achilles tendon area is thoroughly cleaned and numbed.
  • The specialized cells are then injected into the damaged tissue under image guidance.

Post-Procedure Care

Post-procedure care will include the following instructions:

  • You will most likely be able to return to work the next day following your procedure.
  • You will need to take it easy and avoid any load-bearing activities for at least two weeks following your procedure.
  • You will need to refrain from taking nonsteroidal anti-inflammatory drugs (NSAIDs) for a while as this can affect the healing process of your body.
  • You may apply ice to the injection site for comfort.
  • Rest, elevation, and medicines are recommended to relieve pain and swelling.
  • A follow-up appointment will be scheduled to monitor your overall progress.

Risks and Complications

Orthobiologic treatments for an Achilles injury is a relatively safe procedure; however, as with any procedure, there may be some complications, such as:

  • Infection
  • Soreness at the injection site
  • Nerve damage
  • Immune reaction