Bone Marrow Aspirate Concentrate Therapy for Achilles Tendonitis

What causes Achilles tendon injury?

Tendon injuries are a common problem seen in the doctor’s office. There are around 30 million ligament and tendon injuries each year worldwide. The Achilles tendon is one of the most commonly injured tendons. Orthopedic surgeons, pain doctors and podiatrists are now using stem cell therapy for Achilles tendonitis and other tendon conditions.

The Achilles tendon lies at the heel region of each foot. Injury to the tendon can upset the balance between stability and mobility of the foot and heel, which results in abnormal loading that may damage other soft tissues. Achilles tendonitis can be devastating to elite athletes or other people. The tendon is made of elastin and collagen, which has a low cell turnover and poor self-healing capacity. Any chronic tearing and strain can result in tendonitis, which produces heel pain and problems with mobility.

How can stem cells repair an Achilles tendon?

Stem cells injected into the Achilles tendon differentiate into tenocytes, which are specialized tendon cells. Stem cells also paracrine factors and exhibit immunomodulatory effects to promote tendon regeneration. The use of stem cells is a safe and effective therapeutic option for Achilles tendon repair. The cells create healthy new tissues that replace injured or damaged ones.


What types of stem cells exist?

Embryonic stem cells are removed from human embryos that are fertilized in the laboratory. These are removed 4-5 days following the culture process. Adult stem cells are more tissue-specific, and they are used to repair cartilage, bone, tendon, and muscle. The most useful adult stem cells are obtained from the bone marrow, but they can be taken from fat tissue as well.

How are stem cells obtained?

Adult stem cells are most often taken from the iliac crest, which is the bone on the outside of the pelvis. A needle is inserted into the bone, and bone marrow is aspirated through this needle. The stem cells are separated from other marrow cells and expanded in the laboratory.


What are the advantages of stem cells for repairing tendon tissue?

Called tissue engineering, stem cell therapy uses cells, biomaterials, growth factors, or a combination with the aim of directing a sophisticated healing response to encourage tissue repair. Stem cell therapy involves transformation of cells from one form to another. The tenocytes and growth factors allow for tissue to regenerate, so the flexibility and mobility of the structure increases. Mesenchymal stem cells (MSCs) have self-renewal ability. The harvest of these cells is easy, does not cause an ethical issue, and they have ability to transform to needed cells.

Does stem cell therapy work for tendonitis?

According to clinical studies, stem cells are successful for the promotion of tendon repair with chronic tendinopathy and tendinosis. A recent study shown that use of stem cell injections was safe and effective for refractory Achilles tendinopathy, with improvement noted at 4 weeks post administration.


How common is Achilles tendinosis?

According to studies, around 12% of runners, 9% of dancers, and 5% of gymnasts have Achilles tendinosis or tendinitis. The experts estimate that around 10% of Americans have some type of tendinosis during their lifetimes.


Lui PP (2015). Stem cell technology for tendon regeneration: current status, challenges, and future research directions. Stem Cells Cloning, 8, 163-174.

All content has been reviewed and approved by orthopedic specialist Dr. Zvezdomir “Zed” Zamfirov. Dr. Zed’s practice — All Star Pain Management and Regenerative Medicine — proudly serves the Annapolis, Greater Baltimore and Washington D.C. areas.

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