SCAARS · Panama City
SCAARS, Stem Cell Augmented Articular Restoration Surgery, corrects the mechanical problem in your joint and places stem cells where the tissue heals poorly, in one operation, for selected patients who want to keep their own joint.
A surgical treatment. If you are looking for a stand-alone injection, this is not the right service, and we will tell you so.
An unstable joint, a deformed bone, a fracture that healed out of position: the mechanical problem that is wearing out the cartilage is corrected first. Then the cells are placed under direct vision, on the repaired tissue where healing is poorest, to support the healing of your own tissue.
Stem Cell Augmented Articular Restoration Surgery
Developed by Dr. Ricardo Vega-Croker
Instability, deformity, malunion: correct what is damaging the cartilage.
Donor cells placed under direct vision, on repaired tissue where healing is poor.
Selected patients. When the whole joint is damaged, a replacement or a fusion is usually better.
A stand-alone stem-cell injection leaves the mechanics of a joint as they are. SCAARS starts from two linked questions: what is overloading this joint, and where does the damaged tissue heal poorly? Four ideas follow from them.
A ligament injury that does not heal well leaves the joint unstable, and over time that instability damages the cartilage. Some people's long bones are slightly bowed or angled, from a young age or after an old injury; 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. A fracture that was not treated well heals out of position and overloads the joint; in a closely fitted joint like the ankle, a bone that healed even slightly short or turned can be enough, and a standard X-ray may show the bone as healed without showing that it is out of place. In each case the cartilage tends to wear first where the load is wrong, and in the early stages the rest of the joint may still be in good condition. Correcting the mechanics comes first. An injection, of cells or anything else, cannot do that.
Joint cartilage has no blood supply and very few cells, and those cells cannot move into a defect to fill it, so damaged cartilage heals poorly. Some ligaments also heal slowly or incompletely. Bone, by contrast, has a good blood supply and usually heals well once it is fixed in the right position. You need functional cells for a repair to take; SCAARS places donor cells where healing is poorest, to support the functional cells that remain near the lesion.
Cells injected into a joint that keeps overloading the same spot cannot correct that overload. Placed under direct vision, in a lesion the surgery has prepared, and held there with a matrix, gel or membrane, they are meant to stay where they are needed, to support the healing of your own tissue. Whether, and how much, they add to the repair is still being studied.
SCAARS corrects the mechanical problem and adds the cells in the same procedure, with 3D planning in selected cases. It is designed for joints worth keeping. When the damage involves the whole joint, a replacement or a fusion is usually the better option, and you will be told so.
This is the reasoning behind the method. What the evidence does and does not support is explained on the SCAARS page.
SCAARS is a surgical treatment for selected patients. Honest selection is the first part of the treatment, and it starts before you travel.
All joints are treated. These are the situations in which surgical correction may be combined with stem-cell augmentation. Your evaluation decides which operation, and whether adding cells makes sense in your case.
A ligament injury that does not heal well leaves the joint unstable, and over time instability damages the cartilage. Sometimes this follows a fracture, when a ligament torn at the same time did not heal. Surgery aims to restore stability so the joint stops moving abnormally, which is intended to protect the cartilage from further damage; the cells are placed on the repaired tissue.
A bowed or angled long bone, from a young age or after an old injury, makes one side of the joint carry the extra load; with age that side wears first and the angle increases. A corrective osteotomy realigns the bone to move the load toward the healthier part of the joint.
A healed bone is not always a healed joint. A fracture that was not treated well heals out of position and overloads the joint, and a standard X-ray can miss why it still hurts. Reconstruction aims to restore the alignment and relieve the overload before the wear becomes established arthritis; it cannot undo damage already done.
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; damage to the bone beneath is treated according to the case.
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.
Conceptual illustrations. Select a topic to read the complete explanation.
Regions include: Knee · Ankle and foot · Shoulder · Hand · Elbow · Hip.
The cells are cultured from umbilical cord by an independent laboratory in Panama; imported products are also an option. During surgery they are placed on the repaired tissue and, depending on the case, part may also be left in the joint, with the aim of supporting the healing of your own tissue where it is poorest.
Dr. Ricardo Vega-Croker trained in orthopedic surgery and traumatology at Hospital Clínic de Barcelona, with further training in foot and ankle surgery, arthroscopy and joint surgery. His work with 3D anatomical models led to SCAARS: understand the mechanics first, then add cells where the tissue heals poorly.
He personally reviews inquiries sent to the practice by WhatsApp or email. If a replacement or a fusion is the better option for you, he will tell you up front.
Meet Dr. Vega-Croker
The evaluation, the surgical plan, the laboratory, the hospital, your stay if you need help with it, and your follow-up after you return are coordinated personally by the surgeon.
A short WhatsApp or email message is enough. Mention the joint concerned and your country. Dr. Vega-Croker reviews it.
You explain your case and he makes an initial assessment of whether SCAARS could help you, or whether another path makes more sense.
If you could benefit, you receive a treatment proposal and an itemized estimate before you travel.
Evaluation and surgery in Panama City, follow-up during the days after, then teleconsultation once you are home.
Surgery. SCAARS is an operation that corrects the mechanical problem in your joint. Stem-cell augmentation is one part of that operation: the cells are placed under direct vision where the tissue heals poorly. We do not offer stem-cell injections on their own.
From umbilical-cord cultures produced by independent laboratories in Panama; imported products are also an option. You contract and pay for the cell product directly with the laboratory, and Dr. Vega-Croker's professional fees are paid to him through the hospital's and the laboratory's charges. He does not manufacture or sell the cells; he coordinates its use and performs the treatment. Each lot comes with documentation you can review.
Yes. Write a short message first. Dr. Vega-Croker can arrange a video consultation in which you explain your situation and he makes an initial assessment of whether SCAARS could help you. Examination in person and imaging are still needed before any decision.
A short message is enough to start. Dr. Vega-Croker personally reviews inquiries sent to the practice by WhatsApp or email.
