Human amniotic tissue is used in our office to inject chronic soft tissue injuries. We utilize a freeze-dried mixture of powdered human amniotic membrane and umbilical cord, which we rehydrate with saline and inject into a partially torn or chronically injured ligament, tendon or joint to stimulate healing. This is performed under direct ultrasound guidance for accurate placement of the medication. The injection is typically followed by a series of extracorporeal shockwave treatments performed in our office. Use of shockwave is discussed in a separate section of our website.
Amniotic tissue has been used for many years to supplement healing in chronic wounds such as ulcerations and is often used in dentistry and plastic surgery. A donor mother consents to the contribution of placental tissue after a baby is delivered. The donor mothers are carefully screened and tested for any infectious diseases. All processes of screening and handling of the tissues follow FDA guidelines. Almost all placental tissue is derived after C-section for a cleaner specimen. The placenta is composed of two layers including the amnion, which is the layer directed towards the baby. The chorion layer is against the mother The layers are separated and through sterile technique, the amniotic membrane is rinsed with a dilute solution of sodium hypochlorite. Later, the tissue is dehydrated with glycerol solution. It is then freeze-dried, and sterilized. Over 250,000 procedures have been performed with this technology and no problems of tissue rejection have been reported.
Amniotic membrane contains anti-inflammatory and anti-bacterial properties. This membrane also contains many nutrients that have helped the fetus to develop. This includes multiple growth factors (proteins) involved in the repair and production of tissues. Amniotic tissue also possesses mesenchymal (precursor to stem cells) to help promote the production of new tissue. The umbilical portion of this mixture also helps to provide additional growth factors and helps reduce inflammation. Amniotic injections do not contain living stem cells but are high in concentrations of growth factors. Dr. Braver and staff also provide living stem cell treatment, harvesting them from one's own bone marrow, obtained from the leg or harvested from one's own belly fat. This is discussed in a different section of this website.
Our office has had tremendous success with the use of amniotic tissue injections providing this form of treatment for those difficult to heal injuries administered in a precise way under ultrasound guidance. Amniotic injections are considered investigational and/or experimental by insurance companies, but the cost is a few hundred dollars, which is a huge savings compared to surgical intervention. Amniotic injections avoid the complications of atrophy of tissue associated with steroid injections. A repeat amniotic injection may be needed at six weeks to further boost the regenerative process, but these injections help to avoid the need for surgery. Please feel free to contact our office to set up an examination and discuss further treatment options with you or any affected individual regarding many foot, ankle, or leg problems.
Written by Richard T. Braver, DPM, FACFAS
