Effectiveness of prolotherapy in the treatment of chronic rotator cuff lesions

Seven, Mehmet; Erşen, Ömer; Akpancar, Serkan; Özkan, Hüseyin; Türkkan, Selim; Yıldız, Yavuz; Koca, Kenan

doi:10.1016/j.otsr.2017.01.003

Cited by 70 publications

(86 citation statements)

References 31 publications

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“…Following the title screen, 74 studies were included in abstract screening, of which 24 progressed to full‐text review. A total of 20 studies were removed by the full‐text review, leaving four papers to be included for analysis (Figure ) . One additional article was retrieved through manual reference search of included studies.…”

Section: Resultsmentioning

confidence: 99%

“…A total of 20 studies were removed by the full-text review, leaving four papers to be included for analysis ( Figure 1). [18][19][20][21][22] One additional article was retrieved through manual reference search of included studies. Authors were in high agreement throughout all stages of screening, with an unweighted kappa of 0.962 for title screening, 0.760 for abstract screening, and 1.00 for full-text screening.…”

Section: Study Characteristics and Demographicsmentioning

confidence: 99%

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Effectiveness of Dextrose Prolotherapy for Rotator Cuff Tendinopathy: A Systematic Review

Catapano

Zhang

Mittal

et al. 2019

PM&R

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Objective To systematically review and evaluate the efficacy and complication profile of prolotherapy using hyperosmolar dextrose solution injection for rotator cuff tendinopathy. Literature Survey MEDLINE, EMBASE, CINAHL, and the Cochrane Central Register of Controlled Trials (from inception to 1 July, 2019). Methodology A comprehensive search was completed to identify randomized controlled trials addressing prolotherapy using hyperosmolar dextrose solution for rotator cuff tendinopathy. Two reviewers independently screened the titles, abstracts, and full texts, and then extracted data from eligible studies. All reported outcome measures and complications were analyzed descriptively. Synthesis Five studies satisfied inclusion criteria. Included studies analyzed a total of 272 participants with a final follow‐up ranging from 6 weeks to 12 months. Prolotherapy differed greatly among studies. Two studies used a multisite enthesis injection protocol while the other three used ultrasound‐guided protocols. Two of the studies used an intrasubstance supraspinatus injection and three used a supraspinatus enthesis injection. Control groups consisted of nonoperative rehabilitation including physical therapy and medical management in three studies, supraspinatus saline enthesis injection in one study, and corticosteroid injection in one study. There was statistically significant improvement in pain intensity with multisite injection protocols compared to physical therapy and medical management in both studies. Ultrasound‐guided supraspinatus injection trials did not find any statistically significant difference in pain intensity, range of motion, strength, function, or ultrasound characteristics compared to controls of enthesis saline injection or corticosteroid. The complication rate was low, with only 6/272 participants experiencing adverse events consisting of transient increase in pain for 1 to 2 days postintervention. Conclusions Prolotherapy with hyperosmolar dextrose solution is a potentially effective adjuvant intervention to physical therapy for patients with rotator cuff tendinopathy ranging from tendinosis to partial‐thickness and small full‐thickness tears. Further studies are necessary to determine effects in subpopulations as well as optimal technique including dextrose concentration, volume, and location.

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Section: Resultsmentioning

confidence: 99%

Section: Study Characteristics and Demographicsmentioning

confidence: 99%

Effectiveness of Dextrose Prolotherapy for Rotator Cuff Tendinopathy: A Systematic Review

Catapano

Zhang

Mittal

et al. 2019

PM&R

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“…The remaining research is composed mostly of case series. Table 1 presents a list of studies [17‐47] and levels of evidence.…”

Section: Common Regenerative Methodsmentioning

confidence: 99%

“…There is mixed level I evidence for prolotherapy use in rotator cuff tendinopathy. In a 2017 randomized control trial, Seven et al [23] used dextrose prolotherapy in patients with symptoms longer than 6 months' duration and found significant improvements in pain up to a year and significantly improved disability and quality-of-life scores at 6 and 12 weeks and up to 1 year. In addition, this study found significantly greater shoulder abduction, extension, and internal rotation range of motion in the prolotherapy group compared with the physical therapy group; notably, however, there was no difference in external rotation range at any time point [23].…”

Section: Specific Clinical Applicationsmentioning

confidence: 99%

“…In a 2017 randomized control trial, Seven et al [23] used dextrose prolotherapy in patients with symptoms longer than 6 months' duration and found significant improvements in pain up to a year and significantly improved disability and quality-of-life scores at 6 and 12 weeks and up to 1 year. In addition, this study found significantly greater shoulder abduction, extension, and internal rotation range of motion in the prolotherapy group compared with the physical therapy group; notably, however, there was no difference in external rotation range at any time point [23]. Alternatively, Bertrand et al [24] found no significant improvements in pain in prolotherapy-treated patients compared with those treated with saline injected into the tendon entheses; they also found no significant differences in ultrasound-evaluated tendon anatomy at the end of the study.…”

Section: Specific Clinical Applicationsmentioning

confidence: 99%

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Regenerative Sports Medicine: Past, Present, and Future (Adapted From the PASSOR Legacy Award Presentation; AAPMR; October 2016)

Borg‐Stein

Osoria

Hayano

2018

PM&R

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Regenerative medicine has shown dramatic expanse and evolution in the past decade. Within that milieu, physiatrists are taking an active role in research, clinical care delivery, and education. The purpose of this review is to provide a balance among evidence, theory, experience, clinical trends, and the foreseeable future. We focus on the literature that reports the research with the best methodology in each practice area, recognizing that the level of evidence varies substantially among different treatment modalities and conditions. The following elements are included: an overview of the evolution of currently available regenerative techniques, evidence base for each available modality (prolotherapy, platelet rich plasma, bone marrow aspirate concentrate and stem cells, adipose-derived stem cells, and amniotic tissue products), general principles in the application of these treatments, and discussion and a vision of what lies ahead. We expect that practitioners will use this review to facilitate clinical decision making and to provide a core knowledge base to assist when counseling patients. LEVEL OF EVIDENCE: IV.

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Noninvasive management of soft tissue disorders of the shoulder: A clinical practice guideline from the Ontario Protocol for Traffic Injury Management (OPTIMa) collaboration

Côté

Wong

et al. 2021

European Journal of Pain

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Shoulder pain is a common musculoskeletal condition in the general population. In the United States, the annual prevalence of shoulder pain was approximately 9% in adults in the period of 2002-2009 and shoulder pain ranked fourth behind low back pain, knee pain, and neck pain as the most prevalent musculoskeletal condition in 2009 (National Center for Health Statistics, 2011). Shoulder pain is a major cause of disability worldwide (Vos et al., 2016). Furthermore, shoulder pain places a significant economic burden on the healthcare system and society. Employed persons with shoulder pain require a median of 23 days off work in the United States and an average of 39 days off work in Canada (Saskatchewan Workers' Compensation Board,

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Effectiveness of prolotherapy in the treatment of chronic rotator cuff lesions

Abstract: Level of evidence 1.

Cited by 70 publications

References 31 publications

Effectiveness of Dextrose Prolotherapy for Rotator Cuff Tendinopathy: A Systematic Review

Effectiveness of Dextrose Prolotherapy for Rotator Cuff Tendinopathy: A Systematic Review

Regenerative Sports Medicine: Past, Present, and Future (Adapted From the PASSOR Legacy Award Presentation; AAPMR; October 2016)

Noninvasive management of soft tissue disorders of the shoulder: A clinical practice guideline from the Ontario Protocol for Traffic Injury Management (OPTIMa) collaboration

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