The effect of polydeoxyribonucleotide prolotherapy on posterior tibial tendon dysfunction after ankle syndesmotic surgery

Abstract

Rationale:Ankle syndesmotic injuries occasionally require long-term therapy for recovery and can result in tendon injury. Posterior tibial tendon dysfunction (PTTD) is an acquired deformity that can cause flatfoot deformity. The current nonoperative management of PTTD includes nonsteroidal antiinflammatory drugs (NSAIDs), orthopedic devices. Although various treatment options have been attempted, optimal treatments for each stage of the condition are debated. Polydeoxyribonucleotide (PDRN) is effective in healing of chronic wounds associated with tissue damage by attracting tissue growth factors.Patient concerns:A 67-year-old woman who presented at our pain clinic with pain on the inside of ankle. She had a syndesmotic screw fixation 3 years prior. Her ankle pain had persisted after the removal of screws and edema for about 1 month resulting from long-term NSAIDs administration.Diagnoses:The origin of the pain was possibly tibialis posterior muscle and posterior tibial tendon and she was diagnosed as PTTD after syndesmosis surgery.Interventions:Sono guided prolotherapy with PDRN was carried out.Outcomes:Patient showed improvement in the arch of the foot, experienced pain relief, and was able to wear regular shoes without any orthopedic device.Lessons:This case report highlights that PDRN prolotherapy is a safe and efficient therapeutic option for the treatment of PTTD.

Effect of polydeoxyribonucleotide injection on pes anserine bursitis

“…Conversely, PDRN, whose action is derived from anti-inflammatory effects that promote wound healing by tissue regeneration, has no side effects. [ 15 , 16 ] PDRN repairs and regenerates the cellular damage by interacting with A2 purinergic receptor and stimulating the production of vascular endothelial growth factors. [ 15 ] PDRN had recently found a wide application in the medical field.…”

“…[ 15 , 16 ] PDRN repairs and regenerates the cellular damage by interacting with A2 purinergic receptor and stimulating the production of vascular endothelial growth factors. [ 15 ] PDRN had recently found a wide application in the medical field. Lim et al [ 15 ] reported the effectiveness of PDRN injection in posterior tibial tendon dysfunction patients undergoing ankle syndesmotic surgery.…”

“…[ 15 ] PDRN had recently found a wide application in the medical field. Lim et al [ 15 ] reported the effectiveness of PDRN injection in posterior tibial tendon dysfunction patients undergoing ankle syndesmotic surgery. Won-Joong et al [ 17 ] demonstrated the effectiveness of PDRN injection in ischiofemoral impingement syndrome patients who were not indicated for surgery.…”

“…Chronic and acute toxicity studies confirm that PDRN has no toxic effects on the brain, lungs, heart, liver, and skeletal muscle on macroscopic and histologic analysis. [ 15 ]…”

Application of ultrasound-guided C5 nerve root block using polydeoxyribonucleotide in traumatic C5 nerve root injury caused by fracture of the articular process of the cervical spine

“…Recently, polydeoxyribonucleotide (PDRN) has begun to be used for neuropathic and musculoskeletal pain because of it its anti-inflammatory effects. [ 4 , 5 ] Although PDRN has not been studied for bone healing, it is known to promote wound healing through its collagen synthesis effects and by stimulating angiogenesis, unlike corticosteroids. [ 6 ] Moreover, PDRN is also known to have osteoblast-promoting properties, [ 7 ] and prevents cartilage loss.…”