Five situations, all joints.
SCAARS is designed for five kinds of problems. All joints are treated, including the knee, ankle and foot, shoulder, hand, elbow and hip:
1. Ligament injuries that need repair or reconstruction
A ligament injury that does not heal well leaves the joint unstable. The joint then moves in ways it was not built for, and over time that instability damages the cartilage. This can include a ligament that was torn at the time of a fracture and did not heal: the bone heals, but the joint stays loose. A ligament torn with a fracture may heal once the fracture is fixed; one that does not is looked for with examination and imaging. Surgery aims to restore stability so the joint stops moving abnormally, which is intended to protect the cartilage from further damage; it cannot undo damage already done. The cells are placed on the repaired ligament and, depending on the case, in the joint.
2. Alignment problems that need a corrective osteotomy
Some people's long bones are slightly bowed or angled, from a young age or after an old injury. For years this causes no trouble, but with age the side of the joint that carries the extra load starts to wear first, and as that cartilage thins the angle increases: more load on a smaller area of contact. This family also includes early arthritis limited to the overloaded part of the joint. A corrective osteotomy realigns the bone to move the load toward the healthier part of the joint, and works best while that part is still in good condition. It is one of the best-established joint-preserving operations. Whether cells add value alongside the osteotomy is decided case by case.
3. Injuries that healed in the wrong position
A healed bone is not always a healed joint. A fracture that was not treated well can heal out of position: a bone that is slightly short or rotated, or a step in the joint surface. A ligament torn at the same time that did not heal can add to the problem. The joint is left misaligned and overloaded, with the same consequence as a deformity: the cartilage wears where the load is wrong, while a standard X-ray shows the bone as healed. In closely fitted joints like the ankle, even a small displacement can matter. The damage is slow, which leaves a window to restore the alignment before the wear becomes established arthritis; reconstruction cannot undo damage already done. The cells are placed where the cartilage is found to be damaged.
4. Cartilage and osteochondral defects
Localized damage to the cartilage, sometimes including the bone beneath it, surrounded by healthy cartilage. The cartilage defect is prepared and filled with small pieces of your own cartilage, collected during the operation, mixed with the donor cells and held in place with a matrix, while the surrounding cartilage is protected; damage to the bone beneath is treated according to the case.
5. Muscle injuries
Selected muscle injuries that need surgical repair. If cells are added, they are placed on the repaired tissue; evidence for doing so is very limited, and whether it makes sense in your case is discussed with you.
What makes someone a candidate?
Your evaluation considers:
- The mechanical problem: is there a ligament injury, a malalignment, a fracture healed out of position, a cartilage defect or a muscle injury that surgery can correct?
- The pattern of damage: localized, with healthy tissue around it, or spread through the whole joint.
- Symptoms and daily function: what hurts, what you can do and what you want to return to.
- Previous treatment: what has been tried, how it helped and any previous operations.
- Health and recovery: the demands of rehabilitation and your ability to follow a recovery plan, including a stay in Panama.
Age is one consideration. It is not a diagnosis or a decision on its own.
Who SCAARS is not for.
- Patients looking for an injection without surgery. SCAARS is an operation. If what you need or want is a stand-alone injection, SCAARS is not the right service, and we will say so.
- Joints with damage throughout. When the whole joint is worn, a replacement or, in some joints, a fusion usually gives a more predictable result than any preservation procedure. Dr. Vega-Croker will tell you up front.
- Patients who cannot travel for assessment and early recovery. A decision cannot be made remotely, and the days after surgery matter.
- Anyone expecting a guarantee. No treatment guarantees regeneration or that a prosthesis will never be needed.
Know the trade-offs.
Keeping your own joint does not automatically mean a smaller operation, a lower risk or a quicker recovery. Some preservation procedures require a prolonged period of protected weight-bearing and rehabilitation. A successful treatment may delay replacement; it cannot guarantee that replacement will never be needed. Ask how success will be measured for your case: pain, walking, work, sport or another activity that matters to you.
A useful question for your consultation:
“What part of my joint is still healthy, what mechanical problem would the surgery correct, what would the cells add, and how likely is it to improve my daily life?”