Minimally Invasive Autologous Bone Marrow Concentrate Stem Cells in the Treatment of the Chronically Injured Achilles Tendon: A Case Report

INTRODUCTION: Achilles tendinopathy is a painful, degenerative condition that limits mobility in daily activities and physical exertion. When conservative treatment fails, surgery is usually considered. There is a growing development of less invasive treatments to correct affected tendons. BACKGROUND: Autologous Bone Marrow Concentrate (BMAC) contains concentrated growth factors, CD34+ stem cells and mesenchymal stem cells, which have angiogenic, trophic, and anti-inflammatory effects on tissues and may be useful in the regeneration of tendon tissue. AIM – CASE REPORT: We present a case of severe chronic MRI confirmed Achilles tendinopathy in a 56year-old female treated with ultrasound guided injection of autologous Bone Marrow Aspirate Concentrate (BMAC). MATERIALS AND METHODS: In an office setting, bone marrow was aspirated from the metaphyseal area of the medial tibia and concentrated with a closed system. The resulting BMAC was injected intralesionally into the affected tendinotic midsubstance area under ultrasound guidance. RESULTS: Eight weeks after intervention, the patient reported remarkably less pain and had resumed normal daily activities and intense exercise. Her ankle showed markedly less tenderness and progression toward homogenicity on the 10week MRI with T1 relative strength intensity (RSI) improvement from 307.8 to 182.5 units at the most affected area of the lesion. NOTE: Since the publication of this article by CellR4 on July 26, 2014, a 32-week post-treatment MRI was performed using the same scanner as the pre-treatment and 10-week post-treatment MRIs. The 32-week MRI images showed near complete healing of the treated tendon. See the ‘In Press: Editor,’ section later in this report. DISCUSSION: To our knowledge this is the first report of the successful treatment of Achilles tendinopathy using autologous BMAC. CONCLUSIONS: This case report of the non-surgical, minimally invasive use of BMAC to successfully treat chronic Achilles tendinopathy should lead to further controlled studies of this potential alternative to surgical intervention.