Is Regenerative Therapy Effective for Partial Ligament Tears After a Year?

Is self-funded regenerative therapy effective for partial ligament tears one year after the injury?

Hello Doctor, my thumb was injured at the end of November last year while playing tennis when I tried to save a ball, causing it to bend backward.
It was extremely painful at the time and swelled up.
I visited an orthopedic and rehabilitation specialist two weeks later and have been following up since then.
Just last month, I had an MRI of my left thumb tendon, which showed partial tears; out of six tendons, only two or three remain functional.
During my consultation, the doctor informed me that given the duration of the injury, it is unlikely to heal completely, and the rehabilitation (such as wax therapy) would have limited effectiveness.
The recommendation is to perform surgery to cut a segment of the tendon from the wrist for repair, explaining that there are three tendons in the wrist that serve the same function, so it would not affect daily activities, although it might impact strength.

Since I frequently play tennis, I am somewhat concerned, and because it is my writing hand, surgery would likely be inconvenient for a long time.
Although I do not experience significant discomfort regularly, I do feel pain occasionally when I overuse it (such as writing too much or playing for too long), but it recovers after resting.
The doctor mentioned that this pain is due to relying on the remaining tendons.
He also indicated that if I do not undergo surgery, there is a risk of increasing deformity, although I currently do not have any signs of that.
I consulted another physician who told me that after such a long time, regenerative therapy might also be ineffective.

What recommendations do you have, Doctor? If surgery is the only option, will delaying the procedure lead to worse healing outcomes?

Lin Tongxue, 20~29 year old female. Ask Date: 2018/11/02

Dr. Cai Shanglin reply Orthopedics

If the diagnosis is a tendon rupture, early surgical treatment should be undertaken, and prolotherapy is not recommended.

Reply Date: 2018/11/02

More Info

Regenerative therapy, particularly for partial ligament tears, has gained attention in recent years as a potential treatment option. However, the effectiveness of such therapies, especially after a significant period like one year, can vary based on several factors, including the extent of the injury, the specific type of regenerative therapy used, and individual patient characteristics.

In your case, you mentioned suffering a partial ligament tear in your thumb due to a sports injury. After a year of conservative management, including physical therapy and monitoring, you are now facing the possibility of surgery. The recommendation for surgical intervention often arises when conservative treatments fail to yield satisfactory results, especially in cases where there is a significant loss of function or persistent pain.

Regenerative therapies, such as platelet-rich plasma (PRP) injections or stem cell therapy, aim to promote healing by utilizing the body’s own healing mechanisms. While some studies suggest that these therapies can be beneficial for certain types of injuries, their effectiveness can diminish over time. After a year, the likelihood of achieving significant healing through regenerative therapy alone may be reduced, particularly if the injury has not shown signs of improvement.

Your orthopedic specialist's advice regarding surgery is based on the current state of your injury and the potential for further deterioration if left untreated. The concern about the remaining tendons compensating for the damaged ones is valid; over time, this can lead to additional strain and potential complications, such as deformity or chronic pain.

Regarding your question about the timing of surgery, it is generally true that delaying surgical intervention can lead to poorer outcomes in some cases. This is particularly relevant for injuries that have not healed adequately over time. The longer the injury persists without proper healing, the more likely it is that the surrounding tissues may adapt in a way that complicates surgical repair. Additionally, chronic pain and dysfunction can lead to changes in muscle strength and joint mechanics, which may affect recovery post-surgery.

If you are concerned about the impact of surgery on your ability to play tennis and perform daily activities, it is essential to discuss these concerns with your surgeon. They can provide insights into the expected recovery timeline, rehabilitation protocols, and how to minimize the impact on your lifestyle. It may also be beneficial to seek a second opinion from another orthopedic specialist who has experience with sports injuries, particularly in athletes.

In conclusion, while regenerative therapies can be effective for certain injuries, their efficacy diminishes over time, especially after a year. Given your situation, surgical intervention may be the most appropriate option to restore function and alleviate pain. It is crucial to weigh the benefits and risks of surgery and to have an open dialogue with your healthcare provider about your concerns and goals for recovery.

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