Outcomes of Prolotherapy in Chondromalacia Patella Patients: Improvements in Pain Level and Function

Abstract

We retrospectively evaluated the effectiveness of prolotherapy in resolving pain, stiffness, and crepitus, and improving physical activity in consecutive chondromalacia patients from February 2008 to September 2009. Sixty-nine knees that received prolotherapy in 61 patients (33 female and 36 male) who were 18–82 years old (average, 47.2 years) were enrolled. Patients received 24 prolotherapy injections (15% dextrose, 0.1% procaine, and 10% sarapin) with a total of 40 cc in the anterior knee. At least 6 weeks after their last prolotherapy session, patients provided self-evaluation of knee pain upon rest, activities of daily living (ADL) and exercise, range of motion (ROM), stiffness, and crepitus. Symptom severity, sustained improvement of symptoms, number of pain pills needed, and patient satisfaction before treatment and improvement after treatment were recorded. Following prolotherapy, patients experienced statistically significant decreases in pain at rest, during ADL, and exercise. Stiffness and crepitus decreased after prolotherapy, and ROM increased. Patients reported improved walking ability and exercise ability after prolotherapy. For daily pain level, ROM, daily stiffness, crepitus, and walking and exercise ability, sustained improvement of over 75% was reported by 85% of patients. Fewer patients required pain medication. No side effects of prolotherapy were noted. The average length of time from last prolotherapy session was 14.7 months (range, 6 months to 8 years). Only 3 of 16 knees were still recommended for surgery after prolotherapy. Prolotherapy ameliorates chondromalacia patella symptoms and improves physical ability. Patients experience long-term improvement without requiring pain medications. Prolotherapy should be considered a first-line, conservative therapy for chondromalacia patella.

Conservative Management of Second Metatarsophalangeal Joint Instability in a Professional Dancer: A Case Report

“…26,30,46,60 Additional treatments repeat this process, allowing a gradual build-up of tissue to restore the original strength of the area. Studies report that prolotherapy is helpful in treating tendinopathies and ligament sprains, 12,38,39,44,72 joint instabilities, 20,25,32,62,68,75,83 osteoarthritis, [57][58][59]61 and chronic musculoskeletal pain and low back pain when coupled with spinal manipulation or corticosteroid injections. 23,56 However, studies on the effectiveness of prolotherapy for foot and ankle injuries are limited, and blinded studies are lacking.…”

Comparative effectiveness of dextrose prolotherapy versus control injections and exercise in the management of osteoarthritis pain: a systematic review and meta-analysis

“…We excluded one single-arm trial, due to lack of quantitative pain evaluation in patients with patellar chondro-arthropathy,18 one RCT comparing single injection of dextrose with erythropoietin,19 one RCT targeting nonspecific chronic low back pain without definite radiologic evidence of lumbar spine osteoarthritis,20 and two observational studies analyzing data from a published RCT exploring knee osteoarthritis 21,22. The final meta-analysis included one single-arm follow-up trial23 and five RCTs,7,8,24–26 four of which probed knee osteoarthri tis7,23,24,26 and two of which examined hand osteoarthritis 8,25.…”

Comparison of subacromial tenoxicam and steroid injections in the treatment of impingement syndrome

“…[11] Besides, steroids should be used with caution in patients with diabetes mellitus and hypertension.…”