Hypertonic Dextrose Stimulates Chondrogenic Cells to Deposit Collagen and Proliferate

Johnston, Elisha; Kou, Yi; Junge, Jason A.; Chen, Lin; Kochan, Andrew; Johnston, Michael C.; Rabago, David

doi:10.1177/19476035211014572

Cited by 7 publications

(4 citation statements)

References 37 publications

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“…[27][28][29] Topol et al [30] also observed greater knee cartilage re-growth and improvements in pain following dextrose injection via arthroscopy in severe knee osteoarthritis patients. Johnston et al [31] found that hypertonic dextrose solution could stimulate chondrocytes to increase collagen deposition and proliferate. The study conducted by Maniquis-Smigel et al [32] had demonstrated a 48-hour analgesic effect of 5% dextrose solution via epidural injection in patients with lower back pain.…”

Section: Discussionmentioning

confidence: 99%

The effectiveness of dextrose prolotherapy in plantar fasciitis

et al. 2021

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Background: Dextrose prolotherapy (DPT) is considered to be a type of regenerative therapy and is widely used in various musculoskeletal disorders. Plantar fasciitis is a common cause of heel pain that affects the quality of life of many people. We aimed to evaluate the effectiveness and safety of DPT for plantar fasciitis. Methods: PubMed, Embase, and the Cochrane Library were searched from their respective inception dates to June 2021. Only randomized controlled trials comparing DPT and other interventions for plantar fasciitis were included in this review. Standardized mean differences (SMDs) with 95% confidence intervals were calculated for comparison. The outcome measurements included visual analog score, numeric rating scale, Foot Function index, Revised Foot Function index, American Orthopedic Foot and Ankle Score, and plantar fascia thickness. Post-treatment duration was classified as short-term (1–2 months), medium-term (3 months), or long-term (6 months). Results: Six studies with 388 adult patients diagnosed with plantar fasciitis were included for the meta-analysis. In terms of pain scores improvement, DPT was superior to placebo or exercise in the short-term (SMD: −1.163, 95%CI: −2.17 to −0.156) and the medium-term (SMD: −1.394, 95%CI: −2.702 to −0.085). DPT was inferior to corticosteroid injection in the short-term (SMD: 0.781, 95%CI: 0.41 to 1.152). For functional improvement, DPT was superior to placebo or exercise in the short-term (SMD: −1.51, 95%CI: −2.96 to −0.059), but inferior to corticosteroid injection (SMD: 0.526, 95%CI: 0.161 to 0.89) and extracorporeal shock wave therapy in the short-term (SMD: 0.484, 95%CI: 0.145 to 0.822). Randomized controlled trials showed a better pain improvement in the long-term for patients treated with DPT compared to corticosteroid ( P = .002) and exercise control ( P < .05). No significant differences were found between patients treated with DPT and patients treated with platelet-rich plasma. Conclusion: Dextrose prolotherapy was a safe and effective treatment option for plantar fasciitis that may have long-term benefits for patients. The effects were comparable to extracorporeal shock wave therapy or platelet-rich plasma injection. Further studies with standardized protocols and long-term follow-up are needed to address potential biases.

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Section: Discussionmentioning

confidence: 99%

The effectiveness of dextrose prolotherapy in plantar fasciitis

et al. 2021

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“…9 Prolotherapy with hypertonic dextrose has been reported to be effective in reducing pain and improving function in the medium and long terms in patients with KOA. 9 The mechanisms of action of PHD are not entirely clear; in vitro studies have shown that PHD favors the deposition of collagen and metabolic activity of chondrocytes, 48 and it also decreases the expression of MMP-1 49 ; in preclinical studies in animal models, hypertonic dextrose has a trophic repair effect on cartilage. 50,51 In humans, Topol et al 52 reported that hypertonic dextrose induces a chondrogenic effect in individuals with severe KOA, whereas Waluyo et al 53 reported a decreased cartilage degradation effect measured via the reduction of urinary C-terminal telopeptide of type II collagen, which suggests that the main effect of PHD is an antidegenerative and trophic structural stimulus.…”

Section: Intra-articular Injections Of Botulinum Toxinmentioning

confidence: 99%

Intra-articular Injections for Treating Knee Osteoarthritis: A Classification According to Their Mechanism of Action

Arias-Vázquez

2024

J Clin Rheumatol

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“…2 In this study's meta-analysis, the results suggest that HDP is an intervention that seems to be almost as effective as IAI with HA in the short-term follow-up in individuals diagnosed with KOA, and the mechanisms of action of HDP are not widely studied; nonetheless, in vitro studies have shown that hypertonic dextrose favors the deposition of collagen, metabolic activity, and proliferation of chondrocytes. 35 HDP also decreases the expression of metalloproteinase-1 36 and induces analgesia through neurogenic mechanisms, such as the stimulation of the glycine inhibitor receptor that reduces nociceptive transmission. 37 Animal model studies have reported an increase in the cross-sectional area of the treated ligaments, 38 as well as a trophic repair effect on cartilage.…”

Section: Evaluated Hdpmentioning

confidence: 99%

Hypertonic Dextrose Prolotherapy, an Alternative to Intra-Articular Injections With Hyaluronic Acid in the Treatment of Knee Osteoarthritis

Arias‐Vázquez¹,

Tovilla‐Zárate²,

Castillo-Ávila³

et al. 2021

Am J Phys Med Rehabil

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Intra-articular injections with hyaluronic acid are recommended in the treatment of knee osteoarthritis; however, hypertonic dextrose prolotherapy has been reported as effective and safe. The aim was to evaluate the effectiveness of hypertonic dextrose prolotherapy for pain reduction and improvement of function in individuals with knee osteoarthritis in comparison with hyaluronic acid by meta-analysis. The search was performed in electronic databases. Six studies were included (395 participants). No statistically significant differences were found between prolotherapy and hyaluronic acid in pain control in the short-term; however, in the subanalysis that included only the studies that used intra-articular injection within the prolotherapy scheme, an effect was found in favor of the prolotherapy groups (d = −1.33; 95% confidence interval, −2.50 to −0.16; P (z) = 0.03). Also, an effect was found in favor of the prolotherapy group in the improvement in function (d = −1.05; 95% confidence interval, −2.03 to −0.08; P (z) = 0.03). No major adverse reactions or side effects were reported in any of the studies. Hypertonic dextrose prolotherapy seems to be an effective intervention to decrease pain and improve function in knee osteoarthritis, with efficacy similar to intra-articular injections with hyaluronic acid in the short-term follow-up. Nonetheless, better-quality clinical trials are necessary.

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Hypertonic Dextrose Stimulates Chondrogenic Cells to Deposit Collagen and Proliferate

Cited by 7 publications

References 37 publications

The effectiveness of dextrose prolotherapy in plantar fasciitis

The effectiveness of dextrose prolotherapy in plantar fasciitis

Intra-articular Injections for Treating Knee Osteoarthritis: A Classification According to Their Mechanism of Action

Hypertonic Dextrose Prolotherapy, an Alternative to Intra-Articular Injections With Hyaluronic Acid in the Treatment of Knee Osteoarthritis

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