Casper Man Finds Relief from Chronic Ankle Pain with Novel, Minimally Invasive Procedure
CASPER, Wyo. — For decades, Casper businessman Mike Reid lived an active life, seemingly recovered from a long-ago accident that threatened to sideline him. Now 75, Reid recently found himself grappling with debilitating ankle pain caused by osteoarthritis. Traditional treatments offered little relief, so Reid turned to an innovative procedure called transarterial musculoskeletal embolization – TAME for short – performed by Dr. Charles Bowkley, an interventional radiologist at Casper Medical Imaging.
reid’s journey began some 41 years earlier when he “fallen off of a second-story shelf, landed on my ankle and wound up at Wyoming Medical Center.” Surgery repaired the injury, allowing him to live pain-free for decades, yet about 18 months ago, “the old injury start[ed] to flame up,” Reid said, and he learned he had osteoarthritis. His ankle was “bone-on-bone,” he recalled, adding that “all the cartilage was gone.”
The pain became so severe that it interfered with his sleep. A consultation with his orthopedic surgeon revealed that ankle replacement surgery was likely in his future. However, Reid, citing his busy schedule, “did not want to take time off for the procedure.” Pain-killing injections initially provided relief,but their effectiveness waned over time.
That is when a conversation with Dr. Bowkley, a friend and also a medical professional, opened Reid’s eyes to an choice.
TAME is a minimally invasive procedure that utilizes interventional radiology techniques, inserting a catheter into an artery and guiding it to the source of the pain using radiologic imaging. once there, an “embolic” substance is released, blocking blood flow to the tiny, chronically inflamed blood vessels invading the affected joint. By cutting off the blood supply, the associated sensory nerves die off, reducing pain.
Bowkley first learned of the procedure at a medical conference in 2023. He credits Japanese interventional radiologist Dr. yuji Okuno with pioneering the method, which adapts cancer treatment techniques for orthopedic applications, targeting joints, tendons, and soft tissue problems.”It really has wide-ranging applications, and I personally believe it is going to change how we treat chronic musculoskeletal pain,” Bowkley said.
He emphasized that choosing the right candidate is crucial. While initial joint injuries or conditions like tennis elbow often respond to physical therapy, stretching, and over-the-counter anti-inflammatory medications, TAME offers a potential solution for those whose pain persists and worsens, and who might otherwise be prescribed stronger medications, “and even opioids to deal with the chronic pain.”
Bowkley says that TAME “can be a way to avoid or remove all medications.” He added, “By removing all those pro-inflammatory agents and by removing the microenvironment by using this very small particulate embolization you reduce the need for non-steroidal (medications) and you reduce the need for opioids… You can go back about your normal daily life.”
One potential counterargument to TAME is the limited long-term data available, given its relatively recent introduction. While the initial results and a federally approved research study on the National Institutes of Health website show promise, more extensive studies are needed to fully understand the durability of its effects and potential long-term risks.
Prior to Reid, Bowkley had performed TAME on knee patients.The ankle presented a unique challenge due to limited arterial access. Bowkley sought to use a temporary embolic substance composed of two antibiotics, similar to that used by Dr. Okuno in Japan. Many embolic substances manufactured in the U.S. are made of plastic and are permanent, which could risk further arterial damage.
Bowkley worked with Banner Wyoming Medical Center’s pharmacy department to secure approval to purchase and use the specialized substance. The procedure involved inserting a catheter into an artery in Reid’s groin and guiding it to the ankle, where the embolic substance was released.
Reid described the procedure as “easy,” saying, “I went in at 10 a.m. as an outpatient, went into the procedure room and an hour and a half after that I was back up in a room waiting to be discharged.”
Bowkley confirmed that Reid’s case represents the first ankle procedure in Wyoming using the temporary embolic. He is now exploring its application for knee pain, Achilles tendon inflammation, and heel pain.TAME may also be suitable for patients who aren’t candidates for surgery “because of obesity, their age, or the fact they are on a blood-thinning medication,” Bowkley said. “This is literally the perfect option for them because you don’t need to remove the bone, you don’t need to take out the joint… and in a whole lot of patients you can treat the underlying real reason … and get them out of pain.”
Reid is enthusiastic about the results. “It’s just amazing,” he said.”Sure,there are days,when you sit a lot,the first couple of movements are a little sketchy,but then it is right back to normal.”
He now enjoys being “95% pain free,” adding he would “recommend peopel investigate the option.”
Bowkley sees TAME as a natural extension of his skills as an interventional radiologist: “Taking that skill set and just applying it in a slightly different fashion to those inflamed joints was a very easy pivot for me because it’s something I’ve been doing for my whole career.”
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FAQ About Transarterial Musculoskeletal Embolization (TAME)
Q: What is TAME,and how does it work?
A: TAME,or transarterial musculoskeletal embolization,is a minimally invasive procedure that targets chronic joint pain by blocking blood flow to inflamed blood vessels in the affected area. A catheter is inserted into an artery and guided to the site of pain, where an embolic substance is released to cut off the blood supply.
Q: What conditions can TAME treat?
A: While research is ongoing, TAME shows promise for treating osteoarthritis, tennis elbow, golf elbow, frozen shoulder, bursitis of the hip, and certain foot conditions.Q: Is TAME a replacement for surgery?
A: TAME can be an alternative for patients who wish to postpone or avoid surgery, or for those who are not suitable candidates for surgery due to age, obesity, or blood-thinning medications.
Q: What are the potential benefits of TAME?
A: Potential benefits include reduced pain, improved joint function, avoidance of opioid medications, and a quicker recovery compared to surgery.
Q: What is the recovery time like after a TAME procedure?
A: Recovery time is generally short, with most patients able to return to their normal activities within a day or two.
