Shoulder Pain Treated with Platelet Rich Plasma (PRP) & Prolotherapy

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Sebastian Klisiewicz | Integrative Rehab Medicine

Sebastian Klisiewicz | Integrative Rehab Medicine

Күн бұрын

Dr. Sebastian shows how shoulder pain and injuries (rotator cuff tears, labrum tears, arthritis and more) can be treated with comprehensive ultrasound guided Prolotherapy and PRP injections. Dr. Sebastian is a Shoulder and Regenerative Medicine Specialist in Estero, Southwest Florida.
Learn more here: integrativerehabmedicine.com/...
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Пікірлер: 109
@esterowawa
@esterowawa 2 жыл бұрын
Great information Doc!
@sebastianklisiewiczintegra9805
@sebastianklisiewiczintegra9805 2 жыл бұрын
Thank you Jose. Prolotherapy/PRP for shoulder injuries is the best natural alternative to surgery and steroid injections. In our clinic, we see many patients resolve their chronic shoulder pain and regain normal function with a series of PRP treatments (combined with physical therapy and laser therapy). For more info: integrativerehabmedicine.com/conditions-shoulder-pain/
@Ap9leJacks-wy3pq
@Ap9leJacks-wy3pq 8 ай бұрын
Yeah screw that. I’m so glad I’m going under sedation for this on Monday. I don’t care what people think. I’m getting my right hip & shoulder done, under sedation.
@sebastianklisiewiczintegra9805
@sebastianklisiewiczintegra9805 6 ай бұрын
PRP is a great treatment for shoulder and hip pain, the treatment is typically well tolerate with medications, local anesthetic and sometimes nitrous gas. You do not really need conscious sedation for PRP treatments.
@johnojamm5093
@johnojamm5093 3 ай бұрын
I have to do sedation cuz that looks like it hurts, just poking around like it’s just normal
@Truth1000.
@Truth1000. 2 жыл бұрын
Dr. are you doing spinal discs? I want that next. I like your technique. thanks
@sebastianklisiewiczintegra9805
@sebastianklisiewiczintegra9805 3 ай бұрын
I treat chronic back pain from degenerated and torn disc with PRP and Discseel (fibrin). Discseel with PRP can be very effective at treating back pain and sciatica: integrativerehabmedicine.com/discseel-procedure
@bulldogkarma
@bulldogkarma 4 ай бұрын
I would love to hear some feedback from your Patience 2 years after.
@commentbeast3985
@commentbeast3985 Жыл бұрын
Wow where are you located??? What an awesome Dr.
@GDavis49
@GDavis49 Жыл бұрын
Estero Florida
@thirukumaran7280
@thirukumaran7280 8 күн бұрын
NICE WORK . DOCTORS ARE GODS CHILDREN. ANY REPS ARE NEEDED FOR THIS PROC? DOC?
@arginharitounian1871
@arginharitounian1871 2 жыл бұрын
Hi Dr. Sebastian, I'm really interested in Prolotherapy and PRP. I'm currently in residency. I'm wondering what are you preferred needle sizes & gauges for Neck, lower back pain, and shoulder for delivering the medication? thanks a lot for your educational videos.
@sebastianklisiewiczintegra9805
@sebastianklisiewiczintegra9805 2 жыл бұрын
When treating shoulder pain and neck pain with prolotherapy and PRP injections, I typically use 25G red top needles. For back pain treatment with prolotherapy and prp, I use 23G 3" needles or the red top needles.
@devinthomas4866
@devinthomas4866 Ай бұрын
PRP is red, PPP is yellow What did you inject in this patient?
@andrerichard864
@andrerichard864 3 ай бұрын
How much PRP in ml are you injecting into each space?
@jeremycooksey5655
@jeremycooksey5655 Ай бұрын
Just had this done. Didn’t numb me at all. Worse pain I had. Probably worse than gallbladder attck
@mrdune5479
@mrdune5479 11 ай бұрын
I just had PRP and my shoulder is very sore. But if it fixes my issues it was well worth the money! Hoping to regain my shoulder
@sebastianklisiewiczintegra9805
@sebastianklisiewiczintegra9805 10 ай бұрын
PRP is an effective nonsurgical treatment for shoulder pain but it does cause significant soreness for about 4-7 days after the injection. This can be managed with medications and other modalities. Good luck integrativerehabmedicine.com/naples-fort-myers-fl-shoulder-pain-treatment
@basal1989
@basal1989 3 ай бұрын
hey, did it work?
@mrdune5479
@mrdune5479 3 ай бұрын
@@basal1989 honestly it helped at first but I believe I used my shoulder too much after the injection. So after a few weeks the pain came back. But I bought this thing called the rotator reliever and within a few weeks my shoulder was in way better shape. I would recommend the rotator reliever before you try PRP The problem with my shoulder was it was too weak in the stabilizer muscles compared to my moving muscles so I kept injuring myself by straining the rotator cuff in order to fix the problem you need to strengthen the rotator cuff If I could do it all over again I would have done the rotator reliever to strengthen my rotator cup first and then did PRP afterwards. I still have a little bit of damage in my rotator cuff but I'm able to do jiu-Jitsu again and lift weights with minimal issues. I think to fix the remainder of the problem I would need to get another PRP injection
@basal1989
@basal1989 3 ай бұрын
@@mrdune5479 thanks for the Quick answer, i don't have a problem in my shoulder by I have degenerative disc disease and my doctor recommended the PRP. The procedure sounded way too magical when he first told me about so I'm doing my research now and it definetely seems more logical to strenghten the back before doing the PRP. Thanks for the tip
@jblo76
@jblo76 2 жыл бұрын
What type of doctor should I seek out for doing PRP injections? I see this doctor does integrative rehab medicine…is that typically who performs PRP? I’m in Southern California (OC) by the way. Any recommendations would be greatly appreciated. And very informative video, thank you!
@socalstemcelldo
@socalstemcelldo Жыл бұрын
PRP and any orthobiologic injection should be performed by someone with specialized training to diagnose and perform these injections with the use of image guidance (ultrasound or fluoroscopy, depending on the area being treated). They should have knowledge about what to inject for what problem. I actually have 2 clinics in SoCal and specialize in these treatments
@camirocz
@camirocz Жыл бұрын
Had the exact same procedure done yesterday .We ll see how it feels after a few weeks .May 11 2023.
@olivianichole288
@olivianichole288 Жыл бұрын
How are you?
@mrdune5479
@mrdune5479 11 ай бұрын
How bad does your shoulder hurt. Had mine done today
@khaledzkhan7423
@khaledzkhan7423 11 ай бұрын
How do you feel now ?
@camirocz
@camirocz 11 ай бұрын
@@khaledzkhan7423 Getting better but still not healed.
@okthen5000
@okthen5000 7 ай бұрын
​@mrdune5479 how are you now?
@trendtrader8074
@trendtrader8074 6 ай бұрын
Hi doctor I had prp for supraspinatus tendinopathy when do you recommend to do rehab expercises(physical therapy )
@sebastianklisiewiczintegra9805
@sebastianklisiewiczintegra9805 6 ай бұрын
PRP is a great treatment for rotator cuff (supraspinatus) tendinopathy (formerly tendonitis). You need to give you body adequate time to heal, If there is no rotator cuff tear, we typically start very gentle therapy in 1-2 weeks after the PRP. integrativerehabmedicine.com/naples-fort-myers-fl-shoulder-pain-treatment
@nolly485
@nolly485 2 жыл бұрын
Hi, can I ask if PRP injections are effective in treating Osteoarthritis in the AC Joint and has this been proven with patients?
@sebastianklisiewiczintegra9805
@sebastianklisiewiczintegra9805 2 жыл бұрын
PRP can be injected in any joint that has arthritis. This can help decrease the inflammation and provide long term symptoms relief. It can also stimulate some healing of the cartilage and surrounding tissues. It is important to treat all the ligaments that support the AC joint and other parts of the shoulder with PRP and prolotherapy for best results.
@navmNavm-nc2yz
@navmNavm-nc2yz 5 ай бұрын
​@@sebastianklisiewiczintegra9805doc i have mild ac joint arthritis can prp be effective n can it completely heal
@simo-dv5xk
@simo-dv5xk 11 ай бұрын
Hi Dr, can PRP injections relieve chronic tightness in the upper trap muscles due to cervical C5/6 disc hernia?
@sebastianklisiewiczintegra9805
@sebastianklisiewiczintegra9805 10 ай бұрын
PRP of the cervical spine along with nerve hydrodissection of C5v and C5 nerves and the dorsal scapular nerve can be an effective treatment for cervical radiculopathy from a cervical disc herniation, consider a video consultation, integrativerehabmedicine.com/naples-fort-myers-neck-pain-treatment
@DTUFINOPhotography
@DTUFINOPhotography 5 ай бұрын
I have a shoulder labral tear and a cyst on spinoglenoid notch and measures approximately 1.5 X 1.4 x 1.3 Cm. I was given a cortisone shot for pain and it has relived 95% of the pain, but the cyst is definitely pressing up on my nerve cashing severe pain when i didn't have cortisone. Doc suggested shoulder surgery but i cant do that RIGHT now. I'm seeking to try Ultrasound-guided cyst aspiration to prevent it pressing on my nerve... then we can talk surgery but I'm cannot do surgery right now but the pain without cortisone was the worse pain i've ever felt in my life. I'd like to try PRP before full fledged surgery as well.
@spiritfulhealing8605
@spiritfulhealing8605 4 ай бұрын
From what I understand, cortisone does nothing to heal. It reduces inflammation so you feel a temporary relief of pain symptoms. So instead of healing tissue and repair, you now move and rub and work through the site now without pain, so when it wears off you actually did MORE damage and you’ll want another shot
@nikhilgupta144
@nikhilgupta144 10 ай бұрын
Hello dr. Can this prp cure my partial tear in supraspinatus muscle and how long will it take to cure.
@sebastianklisiewiczintegra9805
@sebastianklisiewiczintegra9805 10 ай бұрын
PRP or Bone Marrow Stem Cells are a great nonsurgical treatment for supraspinatus tear (or any rotator cuff tear) as they can potentially heal the tissue. It depends on the size of the supraspinatus tear, and the health of the surrounding tendons and ligaments. If the tear is large, bone marrow stems cells are best, if there is a retraction > 1cm, these injections may not be adequate and you may need surgery. Best to setup a video consultation : integrativerehabmedicine.com/naples-fort-myers-fl-shoulder-pain-treatment
@jaybigboy34
@jaybigboy34 6 ай бұрын
Hello Dr. So i have a bone spur hitting my rotator cuff tendon. It's not torn but frayed a little. Will PRP completely heal this for me?
@sebastianklisiewiczintegra9805
@sebastianklisiewiczintegra9805 6 ай бұрын
PRP is an effective treatment for small rotator cuff tears. Bone marrow and adipose stem cells are a more effective treatment of larger rotator cuff tears. If the bone spur is large and pointed down, it can make the treatment less effective as it will continue to re-injure the rotator cuff tendon. integrativerehabmedicine.com/shoulder-treatment
@proud2bejcan
@proud2bejcan Жыл бұрын
Hello Doctor, I have a small ‘age dependent ‘ labral tear but was diagnosed with frozen shoulder. I’ve been in pain for 7 months now. My arm is very stiff and a bit painful. I’ve received a steroid shot in December and got 3 weeks of relief. Do you think PRP might help? Thanks in advance.
@sebastianklisiewiczintegra9805
@sebastianklisiewiczintegra9805 Жыл бұрын
PRP injections can treat shoulder pain of many causes. We use PRP injections to treat frozen shoulder by doing a joint capsule distention with the PRP, along with treating the syringing tendons, ligaments and hydrodissection of the surrounding nerves. The labral tera may not be as important in this case, but it can also be treated. PRP is a better option than steroids. See more: integrativerehabmedicine.com/conditions-shoulder-pain
@dr.gautamkumar924
@dr.gautamkumar924 Жыл бұрын
Hello sir how treat scatica pain and back pain
@sebastianklisiewiczintegra9805
@sebastianklisiewiczintegra9805 Жыл бұрын
BAck pain and Sciatica can be treated with PRP injections of the spine along with prp lysate epidural. See the 2 videos on treating the back kzfaq.info/get/bejne/ptx0e6aSuMWdp3U.html kzfaq.info/get/bejne/p619eq-HvcvVgIU.html
@teambelltraining8958
@teambelltraining8958 Жыл бұрын
This gives me confidence, I’m receiving the PRP on 10/6
@proud2bejcan
@proud2bejcan Жыл бұрын
How did it go? I am looking into this.
@tomjohn2889
@tomjohn2889 Жыл бұрын
How did it go
@teambelltraining8958
@teambelltraining8958 Жыл бұрын
@@tomjohn2889 OMG!!! I’m 95% better. Back to heavy lifting, golf, anything with no pain. Highly recommended
@KowsikaSri
@KowsikaSri Жыл бұрын
What was your problem
@teambelltraining8958
@teambelltraining8958 Жыл бұрын
@@KowsikaSri I had small tears in the shoulder region restricting movement and lifting
@ReponMiah01
@ReponMiah01 2 жыл бұрын
Hi doctor I want a ittle adviceadviceঃ My left leg hurts when i walk on the left left ankle join so i do MRI asper the doctor advice. Doctor looked the MRI report and said that ny osteoarthritis was caused by secondary osteoarthrits So I don.t have Ist dose PRP Injection on 22/5/22 and I have 2 nd dose PRP injection on 28/6/22 But now that I have pain in my gorali joint I want to know how effective the PRP injection is for my problem I am speaking from Bangladesh
@sebastianklisiewiczintegra9805
@sebastianklisiewiczintegra9805 2 жыл бұрын
PRP can be a very effective treatment for ankle pain (such as caused by arthritis and ankle sprain). The diagnosis needs to be done by a good physical exam of the ankle and foot (and not based on the MRI). All the ligaments and joints involved need to be treated with PRP and prolotherapy for a successful treatment followed by proper rehabilitation of the ankle.
@jimsolmer1292
@jimsolmer1292 Жыл бұрын
Will this heal a bankart lesion or small perforated proximal biceps tendon tear?
@sebastianklisiewiczintegra9805
@sebastianklisiewiczintegra9805 Жыл бұрын
PRP/prolotherapy is a good treatment for an unstable shoulder after a shoulder dislocation. PRP can help heal a torn labrum (bankart lesion) and a biceps tendon tear, it may require multiple treatments or stronger agents such as bone marrow stem cells. With proper prolotherapy and PRP treatments of the shoulder, all the surrounding ligaments and tendons need to be treated to provide stability for the unstable shoulder. PRP, prolotherapy and bone marrow stem cells often provide the needed shoulder stability and help resolve shoulder pain and improve function.
@jimsolmer1292
@jimsolmer1292 Жыл бұрын
@@sebastianklisiewiczintegra9805 when you say 'heal' do you mean it actually heals the tear and makes it like before the tear happened?
@omriloutz8064
@omriloutz8064 2 жыл бұрын
Thanks for the info - nicely done! I do have a question - If a PRP treatment can resolve the chronic pain and regain normal function, what will happen to the tear that caused those pains? will the paitent be able to go back to normal routine and do gym exercises for example with the tear? or will the tear heal itself as well with the PRP injection? this is very intersting.
@sebastianklisiewiczintegra9805
@sebastianklisiewiczintegra9805 2 жыл бұрын
Naturally, more than half of the rotator cuff tears will progress in severity over 1-2 years if not treated. Some may heal, some may remain stable. PRP can actual stimulate a full healing of the rotator cuff tear in small to medium tears. Larger tears will require Bone Marrow Stems Cells to fully heal the tear, this may take ~ 3 months. integrativerehabmedicine.com/conditions-shoulder-pain
@Truth1000.
@Truth1000. 2 жыл бұрын
I had the PRP with Ultra sound guide 6 weeks ago, I can do push ups again, im 200% better. Went to Cellaxys Las Vegas $500, but this Dr. here is using great technique too. mine was Dr. Otten I love prp as an athlete
@ArizonaMMJ
@ArizonaMMJ 2 жыл бұрын
@@sebastianklisiewiczintegra9805 is there any reason to do this if you have been told you are bone on bone and need a shoulder replacement?
@sebastianklisiewiczintegra9805
@sebastianklisiewiczintegra9805 2 жыл бұрын
@@ArizonaMMJ Many structures can cause shoulder pain besides the glenohumeral joint. A good physical exam would identify this. PRP can treat the surrounding tendons and ligaments along with the joint and often is a great alternative to shoulder surgery. PRP can decrease pain and improve function in severe osteoarthritis of the shoulder.
@ArizonaMMJ
@ArizonaMMJ 2 жыл бұрын
@@sebastianklisiewiczintegra9805 thanks
@carlosluisbr
@carlosluisbr 3 ай бұрын
how many shots are needed for shoulder injury? bursitis/tendonitis. thanks
@sebastianklisiewiczintegra9805
@sebastianklisiewiczintegra9805 3 ай бұрын
PRP is an effective treatment for shoulder pain of many causes (rotator cuff tendonitis, bursitis, arthritis). Often all are involved, so many structure need to be treated, it may take 8-12 injections to get all the contributors (causes) of chronic shoulder pain. integrativerehabmedicine.com/fort-myers-naples-bonita-springs-prp-shoulder-pain-treatment
@PeterLambert-iw5yh
@PeterLambert-iw5yh 3 ай бұрын
@@sebastianklisiewiczintegra9805thanks! And that means 18 sessions? Or more than injection are given on a session
@KELOC1
@KELOC1 2 жыл бұрын
How does this heal a labral tear if it’s cartalidge
@sebastianklisiewiczintegra9805
@sebastianklisiewiczintegra9805 2 жыл бұрын
PRP can help heal small labrum tears (shoulder or hip) as the labrum is a fibrocartilage that has some blood supply and capacity to heal if given the right environment. Large labrum tears typically require bone marrow stem cells and or tissue graft to fill the defect. This is coupled with joint protection followed by rehabilitation. This treatment is a good alternative to surgery for labral tears in the right patient. It is definitely not a magic cure for all labral injuries. for more info: integrativerehabmedicine.com/conditions-shoulder-pain
@brookiecookieyaghoubian1255
@brookiecookieyaghoubian1255 2 жыл бұрын
Hi Dr im 17 and have a small labrum tear but I've been injured already for 8 months I want to get back to sports I'm almost 18 stem cells are too expensive. Will prp injection heal my small tear.
@sebastianklisiewiczintegra9805
@sebastianklisiewiczintegra9805 2 жыл бұрын
PRP injection to the shoulder can help heal a labrum in young and healthy individuals, stem cells may be an overkill. This needs to be done under accurate ultrasound guidance. All the other supporting ligaments and joint capsule need to be treated to allow for proper healing and stability of the whole joint (its never just the labrum). Then proper rehabilitation needs to be initiated along with proper dietary support for healing. This can be relatively affordable. Call our office to discuss a consultation: integrativerehabmedicine.com/contact
@20hshih
@20hshih 5 ай бұрын
Hi, I just had my 2nd round of PRP on my left shoulder tendinopathy on 2/15/24. I had PRP injected into my glenohumeral ligament, my supraspinatus (was a microtear), subscapularis. My first round was 7 weeks ago. i tried to keep it as immobile as possible, but it wasn't enough. Today, I had to lift my arm above my head to get my jacket on (since I also had my right shoulder injected) and I heard a crepitus/crack sound and now my biceps feels strained. it's frustrating, but 1) it is possible that the PRP in the surrounding areas will help this biceps feeling? I have had this biceps tendon injected back in 2022. 2) was it a bad idea to get it in both shoulders at the same time? My right shoulder has NEVER been injured before, but I was compensating so much. It was just impossible to get the jacket on and I regret putting my arms up!
@heythere6983
@heythere6983 5 ай бұрын
For me when I got my shoulder done with prp it took Atleast 6 weeks for the initial pain from the procedure to go down and then a few months for it to start to feel normal, this doctor claims the pain goes aaay in 2 days or a week with prp injections in an entire spine. I don’t know about all that . Like I said on another video, I can’t imagine the pain getting your whole spines tendons done at once, I feel like I’d destroy my spine just moving around and I’d need a brace or something , but according to him it’s no big deal . Idk if he has some sorta special prp formula
@20hshih
@20hshih 5 ай бұрын
Thank you for sharing! What tendons or ligaments were injured; and what did your doctor inject? It's so hard to stay immobile in both shoulders when living alone?!?!
@alecsuter2135
@alecsuter2135 2 жыл бұрын
I've just injured my AC joint, a grade 2 I think with a small deformity, I stumbled onto this type of therapy and wondering if it will help. Pity is, don't think this is big in South Africa.
@sebastianklisiewiczintegra9805
@sebastianklisiewiczintegra9805 2 жыл бұрын
PRP is a great treatment option AC joint tears that are stable.
@navmNavm-nc2yz
@navmNavm-nc2yz 5 ай бұрын
Same bro I also injured while doing double bar dips
@seand1011
@seand1011 Жыл бұрын
After having the treatment done, how long until someone can at least drive a car or things like that? Could someone drive home the same day or not?
@sebastianklisiewiczintegra9805
@sebastianklisiewiczintegra9805 Жыл бұрын
PRP injections of the shoulder are very effective in treating shoulder pain and injuries, but the 1st 2-3 days can be challenging due to some pain and weakness. It is best to have a driver and take 3 days off after the procedure.
@jreh3811
@jreh3811 Жыл бұрын
I have had a SLAP repair, a glenoid type b2 and all kinds of arthritis in my shoulder. Doc's have said no replacement as I am too young (52) and active. I am having PRP done in a few weeks as the cortisone shots have lost all effectiveness and HA is not approved for the shoulder and also costs about 500 more than PRP.
@sebastianklisiewiczintegra9805
@sebastianklisiewiczintegra9805 Жыл бұрын
If the PRP is not adequate, consider getting bone marrow stem cell injections for the treatment of shoulder arthritis and labrum tear, see the shoulder stem cells video I just posted: kzfaq.info/get/bejne/bcpjkreAl5mxkYE.html
@hero.alexander
@hero.alexander Жыл бұрын
How did it go ? Did you find relief ?
@autumn1231
@autumn1231 10 ай бұрын
how was your outcome?
@gabrielabarrera8061
@gabrielabarrera8061 5 ай бұрын
Cuestión? Is it better to rest or work the next day.❤
@sebastianklisiewiczintegra9805
@sebastianklisiewiczintegra9805 5 ай бұрын
After a prp treatment for shoulder pain (like rotator cuff tears), it is best to rest for 3 days, then take it easy for 1-2 weeks integrativerehabmedicine.com/shoulder-treatment
@jbspillman
@jbspillman 2 жыл бұрын
How is the patient doing now?
@sebastianklisiewiczintegra9805
@sebastianklisiewiczintegra9805 2 жыл бұрын
This patient was relatively healthy and fit, so one PRP treatment of his shoulder was enough to give him pain relief and return of normal function. Some people may need 2 shoulder PRP treatments. He was actually planning on doing his other shoulder in the future.
@jbspillman
@jbspillman 2 жыл бұрын
@@sebastianklisiewiczintegra9805 just got mine done yesterday.
@stephenlosco9169
@stephenlosco9169 2 жыл бұрын
how did your PRP injection go? What did you need it for?
@jbspillman
@jbspillman 2 жыл бұрын
@@stephenlosco9169 arthritis in shoulders, destroyed mine. It feels a bunch better now, but it will never be the same.
@transworld9819
@transworld9819 2 жыл бұрын
How painful is PRP in the shoulder or Knee? I would like to have it done in both.
@FearOfGeorge
@FearOfGeorge Жыл бұрын
That was not full thickness tear.The goal is not just help the tendon to heal but fix the reason which made the partial tear and that's the impingement... You need to fix the impingement and you can not fix it with prp...
@sebastianklisiewiczintegra9805
@sebastianklisiewiczintegra9805 10 ай бұрын
PRP is a great treatment for small rotator cuff tears, but if there is a significantly downsloping acromium causing the impingement, that would need to be fixed. You also need to treat the ligaments and muscles that support the humeral head from riding up, this can help decrease the impingement integrativerehabmedicine.com/Naples-Fort-Myers-Bonita-prolotherapy-Treatment
@mauromartinez3091
@mauromartinez3091 2 жыл бұрын
Wow 'Look's really simple...Only hear Great Things about PRP..Going to get BULGING DISC DONE ON MY L -4 & L - 5 AND SHOULDERS TEAR / ALSO MY NECK C -- 2 C - 3 after a Fall.at home...Terrible...want my Normal Life back...Want to Wash my own Car and go jogging again.👤 Any reviews from Viewer ?
@Johndoe-nb5cw
@Johndoe-nb5cw Жыл бұрын
I have a 6mm by 4mm infraspinatus tear, would prp help me return to over head lifting?
@sebastianklisiewiczintegra9805
@sebastianklisiewiczintegra9805 Жыл бұрын
This is a large tear of the supraspinatus. PRP alone would not be adequate. To treat such a rotator cuff tear, you would need bone marrow stem cells and possibly an adipose graft to fill in the gap. This would be followed by bracing and careful therapy.
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