Non-Surgical Tendon, Ligament and Joint  Reconstruction 
by William J. Faber, D.O. 
_http://www.prolotherapy.com/articles/fabernstljr.htm_ 
(http://www.prolotherapy.com/articles/fabernstljr.htm) 
 
 
In acute injuries, the ligaments and tendons become torn.  Ligaments function 
to limit the range of motion that bones can move between each  other, and 
function to stabilize joints and hold the joint together. Tendons  function to 
attach a muscle to bone in order to provide motion. Discs and  cartilage serve 
to absorb shock and keep the bones from rubbing against one  another. If the 
ligaments become torn or over-stretched the joint becomes  unstable and 
resultant friction causes the discs or cartilage to become worn  down causing a 
loss 
of height. The disc and cartilage may also become worn away  by repeated 
motion. This loss of height causes further ligament laxity and thus  more 
instability. The friction of the joint is a stress. Bones respond to stress  by 
making 
more bone. This results in bone spurring which is the body*s attempt  to splint 
or stabilize the unstable joint. Degenerative disease is merely the  body's 
attempt to stabilize joints as the tendons and ligaments have not been  able to 
heal because of lack of blood supply. If a patient has considerable  
degenerative arthritis, the loss of disc or cartilage height causes a laxity of 
 the 
supporting ligaments. This causes joint instability. Reconstruction has been  
shown to be effective in these conditions, causing the lax ligaments to become  
strengthened, thus stabilizing the joint and allowing for increased function 
and  endurance. 
 
Reconstruction therapy (also known as sclerotherapy and proliferative) is 
given by a slender needle  similar to the hairline needles of the 
acupuncturist, 
into the fibro-osseous  junction. This is the area where the tendon or 
ligament attaches to the bone.  The substance used is sodium morrhuate which 
comes 
from cod liver fish oil and a  local anesthetic. Repeated studies at the 
University of Iowa have shown that  areas injected have increased in size by 
35% to 
40%, thus causing permanent  strengthening. 
 
Therapy Benefits 
 
Each treatment session results in more and more tissue being  laid down in 
the needed areas. As a result, the joints continue to become  stronger. The 
patient notes more endurance, they can do more activities, as well  as 
activities 
they couldn*t do before. The main side effect of the treatment is  less pain 
as a result of the joint being stabilized. Also, snapping, clicking,  and 
popping sounds go away or decrease. The patients can usually feel the joint  
becoming stronger with each treatment they receive. 
 
In Dr. George S. Hackett*s monograph Ligament and Tendon  Relation Treated by 
Prolotherapy, illustrations #5 and #6 show normal rabbit  tendons which have 
been injected three times each. The tendon on the right has  been given a 
proliferative solution. The left tendons have been given placebo  injections. 
Hackett found that the tendons injected with the proliferative  solutions were 
35% 
to 40% larger in diameter and weight compared to the control  injected left 
tendon. In his monograph and article in the Journal of the  American Medical 
Association, Hackett states that 1600 patients with severe  sacroiliac sprain 
were treated with reconstructive injections. They were  examined by independent 
physicians 2 to 12 years after treatment was completed  and 82% remained free 
of pain or recurrences. 
 
Double-blind Study Demonstrates  Reconstruction Success 
 
In a study at the Sansum Medical Clinic of Santa Barbara,  California led by 
Robert Klein, M.D., a rheumatologist, and Thomas Dorman, M.D.,  an internist, 
they conducted the most difficult task of a double-blind study in  the most 
difficult cases of continuous low back pain patients who suffered for  ten 
years 
or longer. They divided 81 patients who had surgery, medications,  
manipulations adjustments, exercise, physical therapy and other treatments 
which  failed 
to provide adequate relief for 10 or more years. 
 
One group was given manipulation and a reconstructive solution  of dextrose, 
glycerine and phenol. The other group was given sham manipulations  and normal 
saline injections. Great care was taken to insure that neither the  patient 
nor the physicians knew which solution was injected. Both groups were  given a 
total of six treatments. It was found that 88% of the group injected  with the 
reconstructive solution had moderate to marked improvement. They  reported 
their findings in the prestigious British medical journal, The Lancet  on July 
18, 1987. 
 
40% More Strength and Endurance Proven  Possible 
 
Harold Walmer, D.O. of Elizabethtown, Pennsylvania has  performed 
reconstructive therapy since 1952. He became interested in the marked  increase 
of the 
white areas of the X-rayed tendons of Dr. Hackett. He  spearheaded the research 
which further explored the question of increased  strength caused by 
reconstruction therapy. At the University of Iowa Department  of Orthopedic 
Research, 
medial rabbit knee ligaments were injected with sodium  morrhuate 5% three 
times. Sodium morrhuate is an FDA approved substance purified  from distilled 
cod 
liver fish oil. The control ligaments were injected three  times with normal 
saline solution. The ligaments were then mechanically pulled  from the bone and 
the force required was recorded. It was found that mechanical  strength of 
the morrhuate injected ligaments was some 25% to 40% over the normal  ligament. 
Dr. Walmer states that this is consistent with the clinical results he  and 
other skilled reconstruction therapists have noted for many years. Dr.  Walmer 
feels that it is this 35% to 40% increased structure as well as  mechanical 
strength over normal, that makes the therapy so exciting and dramatic  in the 
results frequently obtained. He postulates that the above observations  may 
explain the fact that numerous patients with severe conditions of long-term  
advanced degeneration of bones, discs, cartilage, joints, tendons, ligaments,  
failed surgery, compression fractures, polio, muscular dystrophy and other  
advanced musculoskeletal problems have been seen to have dramatically improved  
strength and endurance, allowing them to literally throw away wheelchairs,  
walkers, crutches, braces and other aids. Dr. Walmer is pursuing grant money 
for  
another university study to measure before and after strength of severely  
degenerated joints. He feels that people in wheelchairs and other severely  
weakened 
joint conditions may leave the patient with only 20% of the normal  strength. 
Since reconstruction therapy has been shown to increase size and  strength by 
35 to 40% over normal, he speculates that increases of over 100% may  be 
possible. Dr. Walmer feels that grant research funds would be well-spent in  
these 
times of increased medical and surgical costs, for more studies on this  
life-restoring biological therapy. The therapy is estimated to be 3 to ten 
times  
more cost effective than joint surgery, joint replacement or spinal surgery.  
Studies need to be done so that costs and rewards of the treatment can be  
evaluated. James Carlson, D.O., Knoxville, Tennessee, orthopedic medicine and  
sports medicine specialist and past president of the American Association of  
Orthopaedic Medicine, states that any pain or discomfort associated with  
receiving multiple injections is made up for ten-fold in benefits received from 
 the 
therapy. 
 
Kent Pomeroy, M.D. of Scottsdale, Arizona, a rehabilitation  specialist and 
president of the American Association of Orthopaedic Medicine,  says dramatic 
results should be noted by the patient within the first week after  the 
injections, provided no severe swelling is present. If swelling occurs after  
the 
treatment, the patient needs to wait until the swelling subsides before they  
can 
note improved strength and endurance. If marked improvement is not obtained  
after the first few treatments, then further laboratory examination is  
recommended to find why the patient cannot reconstruct tissue. 
 
How New Tissue is Made 
 
Biology has very few laws but one is the Arndt-Schultz Law. It  states that 
small stimuli are stimulating; Large stimuli tend to inhibit. For  example, a 
little electrical current stimulates circulation and healing. A large  
electrical stimulation causes decreased circulation and cell death. Mild  
irritating 
reconstructive solutions cause dilation of blood vessels and a  migration of 
fibroblasts (healing cells) to the injured areas. 
 
The fibroblasts then lay down collagen which is structural  protein to repair 
the area. The University of Iowa and Dr. Hackett's research  substantiate 
this re-growth. 
 
The Results of Reconstructive Therapy are  Permanent 
 
Rodney Chase, D.O. of Bethlehem, Pennsylvania, a joint  reconstruction 
therapist for over 30 years, has stated that because new tissue  is created, 
the 
results must be considered permanent. He further advises that  patients with 
loss 
of disc, cartilage, bone anatomy from surgery, fractures or  degenerative 
disease, and those with severe scoliosis receive periodic  treatments after 
they 
reach their maximum level of improvement. Dr. Chase  explains that with loss 
of structures, structural height or deformities, these  patients have been 
helped significantly but need periodic treatment to maintain  their optimal 
level 
of strength and function. 
 
Contraindications and Side  Effects 
 
John Sessions, D.O., a reconstruction therapist and biological  practitioner 
from Kirbyville, Texas, finds that the main side effect is less  pain. This 
sometimes makes people think that they are cured and they overuse the  treated 
body part. Dr. Sessions reminds them that reconstruction therapy is a  natural 
process like growing grass from seed. **You don*t play baseball on new  grass. 
You let it grow up to its maximum growth, then you can play ball on  it.**
 
William Kubitschek, D.O. of San Marcos, California states that  a 
contraindication to the therapy is getting the therapy from a physician who  
has not 
specifically trained in reconstructive therapy. Further, Dr. Kubitschek,  in 
speaking as Director of the Board and founding Director of the American  
Association of Orthopaedic Medicine, states that **reconstructive therapists  
should 
know how to use various solutions in all the anatomical areas of the body  if 
they are D.O.*s or M.D.*s. Dentists and podiatrists who use the therapy have  
been specifically trained in reconstruction therapy. Those not specifically  
trained in performing reconstruction therapy are simply not qualified to 
comment  
on its indications and use of this specialized therapy.** The main side-effect 
 of the therapy is less pain. The main effects are reconstruction and 
increased  strength. It is not uncommon for joints to swell after injection. 
This may 
last  a few days to a week or longer. The treating reconstructive therapists 
should be  contacted for any problems and follow-up. Refer to chapter 5 and 
other pages of  Pain, Pain Go Away for further discussion.
 
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