Foot & Ankle

Interview with Dr. Otten about Orthobiologic Foot and Ankle Pain Treatment

By Last updated on April 5th, 2020 Last updated on April 5th, 2020 No Comments

It is truly fascinating how complex the foot and ankle structures are. It is even more fascinating when you learn how much pressure these structures have to endure with our every move, carrying the vast majority of our bodyweight. Dr. Matthew HC Otten, an ambassador of naturally regenerative therapy, explains why our feet hurt and how to fix the pain.

Did you know that every time we take a step, for every pound above the waist, our feet have to deal with 7 pounds of sheer pressure? “If you think about that, every time you step, you have at least 100 pounds up top that’s placing 700 pounds of force on the ankle,” Dr. Otten explains.

The foot and ankle have to bear a tremendous amount of force in weight throughout our daily activities. Because of this, they begin to wear down fast.

Previously, foot and ankle problems were prescribed physical therapy, medicinal cannabis, or downright surgery.

In the advent of both stem cells and PRP, however, we now have non-operative solutions to both foot and ankle pain.

“One of the more common things that we see is Achilles tendonitis. Previously, Achilles tendonitis has been treated with immobilization for 6-8 weeks, or surgical intervention with the same downtime,” says Dr. Otten.

Besides the risk to your health, there are major downsides to have a surgical intervention. For one, you lose the vast majority of your muscle mass during that time, and it takes a long period of time—up to a year—to fully recover. Patients are often left with stiffness and pain after surgery, if they chose to go that route.

“Often times, the professional athletes are now choosing orthobiologic therapies for their treatments with regards to their pain and injuries in their feet and ankles. It’s for this reason that the general population, including myself, and my family and friends, are now turning to stem cells and PRP,” Dr. Otten says in the interview.

“Because professional athletes have had such great success rates with PRP and stem cells, that the general population (started considering orthobiologic treatment) […] to treat their foot and ankle pain,” he adds.

What Causes our Ankles to Hurt?
There are many possible root causes for pain in the foot and ankle domain. Dr. Otten provides guidance:

“Some of the more common problems that we see on a daily basis here at CELLAXYS are Achilles tendonitis—whether it be a partial tear, new or old—plantar fasciitis, posterior tibial tendonitis, as well as a couple of other differential diagnoses. The ankle joint is another very common problem that we see.”

To understand foot and ankle pain causes, it is helpful to have a general idea of the structure of the joints and surrounding soft tissue.

The ankle joint is made up of three major bones, two lay bones and one foot bone. They glide on each other, and the ankle bones are covered in articular cartilage, which wears down over time.

Because of the fact that one pound above the waist equals seven pounds of force on the foot and the ankle, the cartilage of the ankle is prone to injury, thinning and wear-and-tear.

But if surgical intervention is ineffective in restoring damaged cartilage, what are your options?

Stem Cells and Platelet Rich Plasma to Restore Cartilage and Alleviate Pain
“Before the advent of stem cells and PRP, there was really no alternative to help regenerate the cartilage within the ankle. In the last 15-20 years, with the utilization and popularization of orthobiologic therapies, we now have found an alternative to surgical intervention to help stimulate the growth and the health of the articular cartilage of the ankle,” Dr. Otten explains.

During the last 7 years, it has been increasingly popular for patients to be recommended an ankle fusion procedure. Here is Dr. Otten’s take on the matter:

“Ankle fusion is a very, very hard surgery. Basically, the bones are fused, and a significant loss of motion and flexibility happens.”

In many cases, the utilisation of stem cells can alleviate or negate the necessity for the surgery for up to 5-7 years in various patients.

“Our preferred procedure with chronic arthritic ankles that require a fusion is adipose stem cells. Not only you harvest a tremendous amount of stem cells from the adipose tissue, but your own adipose tissue creates a cushioning effect that can last upwards of 1-2 years before the stem cells take effect.” the lead physician explains.

Pain relief can be seen within 3 months after a stem cell procedure in patients requiring ankle fusion surgery.

What about the Achilles?
According to Dr Otten, the Achilles, as well as all the other major ligaments and tendons of the foot and ankle “respond beautifully” to both PRP and stem cell therapies. These procedures often negate the necessity for surgical intervention in the ankle.

“Our success rates tend to be over 90% or greater for injuries of the soft tissue, ligaments and the tendons in the foot and ankle,” the physician emphasizes.

During your procedure, live ultrasound is absolutely necessary for injecting the proper locations to foot and ankle.

“The foot and ankle is mostly composed out of soft tissue, and ultrasound is needed for soft tissue injections. If the substance is injected into an actual ankle joint itself, it is important to use live X-rays to inject the ankle joint with stem cells or PRP during the procedures,” Dr. Otten advises.

During your consultation as well as the procedure day itself, it’s important to take into account all of the dysfunctions and all of the minor injuries that have occurred within the ankle. Most often, you won’t focus just on the injury, but focus on the surrounding soft tissue, including the ligaments and tendons as well.

It is normal to inject locally into multiple locations during an ankle procedure to maximize the success rate.

“It’s our opinion at CELLAXYS, after performing multiple injections and therapies over the course of the last 10 years, that utilizing orthobiologic therapies to actually heal foot and ankle injuries is a much more effective short-term and long-term solution to address the pain. Both stem cells and PRP are used widely in the treatment of foot and ankle,” Dr. Otten says in the interview.

Dr. Matthew HC Otten

Dr. Matthew HC Otten

Director of Orthopedic & Orthobiologics
Fellowship-trained & Board Certified in Sports medicine
Director Angiography at Harvard Clinical Research Institute
Michigan Stage University Alumni