Interventional orthopedics allows doctors to use exacting injection techniques to replace invasive surgeries with innovative and less invasive procedures.

The patient was a Cirque du Soleil performer with a nasty cartilage lesion in the tibial (top) part of her main ankle joint. She didn’t start out seeking an alternative to ankle surgery. Since her cartilage was intact but poor, a surgeon removed the cartilage and then poked holes in the bone in an ankle microfracture surgery. This left the patient with a hole in her cartilage and a pit in her bone, and she then developed a large bone cyst adjacent to the pit, and large bone-marrow lesions. At this point she turned to interventional orthopedics.

Using a precise imaging procedure, 15 special small-gauge needles were used to inject stem cells into the exact locations of her bone lesions (subchondroplasty), as well as into the ankle joint where her cartilage was in trouble. Most clinics now offering stem cells would inject them blindly somewhere in the vicinity of the ankle joint, or if the doctors were more diligent they might use an ultrasound to place the needles. In the case of our Cirque du Soleil performer, however, ultrasound would be incapable of seeing inside the joint at the proper depth or of seeing inside bone, so there would be no way accurately to place stem cells in the joint or into her bone lesions.

“Ankle Surgery Alternative” first appeared as a post on the Regenexx blog.