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Prolotherapy injection for Achilles tendinopathy
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Lyftogt [30]
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Prolotherapy and Achilles tendinopathy: A prospective pilot study of an old treatment.
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To assess the clinical effectiveness of prolotherapy in the treatment of AT in a general medical/sports medicine setting with three-month follow-up; and a postulated positive relationship between initial VAS scores and number of treatments.
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Prospective case series.
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Location: New Zealand.
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Intervention:
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Pain results were monitored with individual prolotherapy recovergrams which were compiled in a study recovergram. A satisfaction survey was also performed.
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Insertional AT.
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Sex: 4 female, 12 male.
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1 mL subcutaneous prolotherapy, dextrose 20 %/lignocaine 0.1 %; at weekly intervals where possible.
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Mean age: 48.0.
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Lyftogt [31]
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Subcutaneous prolotherapy for Achilles tendinopathy: The best solution?
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Reporting on treatment of chronic midportion AT with subcutaneous prolotherapy.
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Prospective case series.
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Location: New Zealand.
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Intervention:
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Follow up was conducted by an independent party with a standard questionnaire assessing VAS pain scores and overall satisfaction.
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Not defined.
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Sex: 59 female, 85 male.
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1 mL subcutaneous prolotherapy, three different dextrose/local anaesthetic regimens; at weekly intervals where possible.
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Mean age: 48.0.
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Maxwell et al. [32]
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Sonographically guided intratendinous injection of hyperosmolar dextrose to treat chronic tendinosis of the Achilles tendon: a pilot study.
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Reporting on treatment of chronic AT with injections of hyperosmolar dextrose under sonographic guidance, to induce an inflammatory reaction and initiate a wound-healing cascade and subsequent collagen synthesis.
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Prospective case series.
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Location: Canada.
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Intervention:
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Improvement in VAS1, VAS2 and VAS3; satisfaction rating, as well as sonographic measurements of tendon thickness, size of hypoechoic region and intratendinous tear size.
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Acute Achilles tendonitis or symptoms associated with acute trauma, surgery or interventional procedures in 3 months prior to trial.
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Sex: 11 female, 25 male.
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≤2 mL prolotherapy, dextrose 25 %/lignocaine 1 %; every 6 weeks until either the symptoms resolved or no improvement.
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Mean age: 54.0.
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Ryan et al. [33]
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Favourable outcomes after sonographically guided intratendinous injection of hyperosmolar dextrose for chronic insertional and midportion Achilles tendinosis.
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To report on changes in the short-term sonographic appearance at two year follow-up for pain outcomes in a large population with chronic AT who underwent sonographically guided injections of hyperosmolar dextrose.
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Prospective Case series.
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Location: Canada.
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Intervention:
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Improvement in VAS1, VAS2 and VAS3; as well as sonographic measurements of tendon thickness, size of hypoechoic region and intratendinous tear size.
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Not defined.
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Sex: 41 female, 58 male.
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≤2 mL prolotherapy, dextrose 25 %/lignocaine 1 %; every 6 weeks until either the symptoms resolved or no improvement.
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Mean age: 54.0.
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Yelland et al. [34]
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Prolotherapy injections and eccentric loading exercises for painful Achilles tendinosis: a randomised trial.
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To compare the effectiveness of eccentric loading exercises (ELE); based on Alfredson protocol, with prolotherapy used alone and in combination for painful AT.
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Single-blinded randomised controlled trial.
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Location: Australia.
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Intervention:
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Improvement in VISA-A, pain stiffness and limitation of activity scores, satisfaction rating and treatment costs.
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Previous steroid or prolotherapy or surgery to affected tendon, previous completion of >50 % of the Achilles ELE protocol, and allergies or medical conditions that may limit completion of treatments.
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Sex: not defined, 43 total participants.
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≤5 mL dextrose 20 %/ lignocaine 0.1 %/ ropivacaine 0.1 % for 4–12 treatments (n = 15); vs Comparator a): Combination of prolotherapy plus ELE (n = 14); vs Comparator b): ELE (n = 14).
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Mean age: 46.7.
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Prolotherapy injection for Plantar fasciopathy
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Kim et al. [35]
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Autologous platelet-rich plasma versus dextrose prolotherapy for the treatment of chronic recalcitrant plantar fasciitis.
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To determine the efficacy of autologous PRP compared with prolotherapy in participants with chronic recalcitrant plantar PF.
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Single-blinded randomised controlled trial.
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Location: Korea.
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Intervention:
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Pain, disability and activity limitation subscales, measured by means of the FFI.
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Local steroid injections within 6 months or nonsteroidal anti-inflammatory drugs within 1 week prior to randomisation, active bilateral PF, or previous surgery for PF.
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Number: 10 female, 11 male.
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2 mL dextrose 15 %/lignocaine 1.25 % (n = 11); vs Comparator: 2 mL of autologous PRP (n = 10). Two injections into the plantar fascia at interval of 2 weeks.
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Mean age: 37.0.
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Ryan [36]
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Sonographically guided intratendinous injections of hyperosmplar dextrose/lignocaine: a pilot study for the treatment of chronic plantar fasciitis.
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To report on the effectiveness of sonographically guided injections of hyperosmolar dextrose at reducing the pain associated with chronic PF.
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Prospective case series.
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Location: Canada.
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Intervention:
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VAS1, VAS2 and VAS3, foot function index (FFI) were recorded at baseline and at final treatment consultation (post-test).
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Acute plantar foot pain or symptoms associated with acute trauma. Surgery or interventional procedures within previous 6-months.
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Number: 17 female, 3 male.
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≤2 mL dextrose 25 %/ lignocaine 1 %; injected sonographic guidance; 6-week intervals.
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Mean age: 51.2.
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Prolotherapy injection for Osgood-Schlatter Disease
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Topol [37]
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Hyperosmolar dextrose injection for recalcitrant Osgood-Schlatter disease.
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To examine prolotheapy versus lignocaine injection versus supervised usual care to reduce sport alteration and sport-related symptoms in adolescent athletes with OSD.
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Double-blinded randomised controlled trial.
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Location: Argentina, USA.
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Intervention:
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The Nirschl pain phase scale (NPPS) was used to assess Unaltered sport (NPPS <4) and asymptomatic sport (NPPS = 0) were the threshold goals.
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Not defined.
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Sex: 3 female, 51 male.
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≥2 mL dextrose 12.5 %/lignocaine 1 % solution (n = 21); vs Comparator a):≥2 mL lignocaine 1 % solution (n = 22); vs Comparator b): Supervised standard therapy (n = 22).
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Mean age: 13.3.
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