Is it worth forking out a lot of money for stem cell treatment for your Achilles injury? Sports physio Maryke Louw explains what stem cell treatment for an Achilles injury entails. She also digs into the research and finds that there are still many challenges and unanswered questions regarding this relatively new medical procedure. Remember, if you need help with an Achilles injury, you're welcome to consult one of our team via video call.
The terms tendinitis, tendonitis, tendinosis, and tendinopathy mean the same thing for all practical purposes, and we use these interchangeably in most of our articles.
In this article:
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What is stem cell treatment?
Stem cells are cells that haven’t differentiated yet, so they have the ability to transform into a wide variety of other cells. You can harvest stem cells from various tissues; bone marrow, tendons, and fat are the most common sources.
The thinking with stem cell treatment for Achilles tendon injuries (and other injuries) is to introduce these cells into the injured area, where they will turn into new, healthy cells of the type that was injured and reproduce quickly to repair the injury, thereby speeding up the healing process.
This sounds quite nifty, but things aren’t as simple as they sound:
If you use donor cells, your body may reject them and have an inflammatory reaction.
The tissue from which the stem cells are being harvested might get injured.
Some types of stem cell are painful to harvest, e.g. from bone marrow.
Researchers are still trying to figure out what is the best way to get the stem cells into the injured area. Injection seems to be the best option for now, but the stem cell survival rate with this isn’t great.
The stem cells don’t always stay in the area in which you place them.
They don’t always replicate and grow.
The stem cells could turn into the “wrong” type of cell, e.g. some stem cells could turn into bone or fat cells and not tendon cells, leading to calcification or fat in the tendon – there isn’t enough evidence to point at which type of stem cell is the safest in this regard.
Does Achilles stem cell treatment actually work?
Most of the research on stem cell treatment for tendon injuries thus far has been done on animals. The results do seem to suggest that it can help to repair tendons and increase their strength after the tendon has been ruptured.
The studies on stem cell treatment for human tendon injuries are scant, and not of much use specifically for Achilles injuries:
Most of these studies were done on the rotator cuff tendon.
Most of them used fewer than 20 participants, which is not a large enough sample size from which to draw definitive conclusions.
Many of the studies didn’t have a control group that didn’t receive the stem cell treatment, so we don’t know whether people’s tendons improved thanks to the stem cell treatment or thanks to the passage of time and natural healing.
Where there were control groups, the results of the stem cell treatment group did not massively outperform those of the control group.
We also don’t know what the long-term results would be – does stem cell therapy improve your long-term outcome, or does it simply lead to a slightly quicker recovery but the same long-term results as other treatments?
Not all the studies concluded that the stem cell treatment was effective.
However, it does seem that stem cell therapy for injured tendons is safe and doesn’t have serious side effects.
What is my take on this?
Stem cell treatment is expensive. So, you have to ask yourself: Is it worth spending the money if I'm only going to have a bit less pain than the person who didn't spend that money and just did rehab?
For now, based on what the research is telling us, I would not get stem cell therapy for an Achilles injury. I get the impression that the people in the white lab coats are still trying to figure out how to use stem cells effectively to treat tendons. So, I would rather let them experiment on somebody else!
And it is not even clear yet whether stem cells actually speed up healing:
Larger studies might show that the relatively small advantage that these small studies have indicated disappear when you average things out in a larger group of people receiving the treatment.
Worse, there might be serious side effects that have gone unnoticed in these small groups of participants.
If you would like to know more about treatments for various types of Achilles injury that have been thoroughly researched and have withstood the test of time, have a look at these articles on our website:
How we can help
Need help with your Achilles injury? You’re welcome to consult one of the team at TMA online via video call for an assessment of your injury and a tailored treatment plan.
We're all UK Chartered Physiotherapists with Master’s Degrees related to Sports & Exercise Medicine or at least 10 years' experience in the field. All of us have a wealth of experience working with athletes across a broad variety of sports and ranging from recreationally active people to professional athletes. You can meet the team here.
About the Author
Maryke Louw is a chartered physiotherapist with more than 20 years' experience and a Master’s Degree in Sports Injury Management. Follow her on LinkedIn and ResearchGate.
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