Ultrasound‐guided Prolotherapy with Polydeoxyribonucleotide Sodium in Ischiofemoral Impingement Syndrome

Abstract

Ischiofemoral impingement syndrome is an uncommon disorder defined by hip pain caused by the narrowing of the space between the ischial tuberosity and lesser trochanter with associated entrapment of the quadratus femoris muscle. We effectively treated two male patients using ultrasound-guided prolotherapy with polydeoxyribonucleotide sodium mixed with local anesthetics. A 24-year-old male patient with no history of trauma or surgery complained of bilateral hip and groin pain; magnetic resonance imaging demonstrated slight narrowing of the bilateral ischiofemoral spaces with mild enhancement of the left quadratus femoris muscle. A 23-year-old male patient with a history of iliotibial band release and iliopsoas tendon release complained of left hip and groin pain; magnetic resonance imaging revealed swelling of the left quadratus femoris muscle. After the fifth treatment session of prolotherapy, the pain severity score using the visual analog scale was found to be minimal (0-1/10), and follow-up magnetic resonance imaging revealed a slightly decreased enhancement of the quadratus femoris muscle compared with that on previous images. Prolotherapy with polydeoxyribonucleotide sodium was an efficacious treatment for two patients with ischiofemoral impingement syndrome who were not candidates for surgery.

Viscoelastic interactions between polydeoxyribonucleotide and ophthalmic excipients

“…It is also known to bind with adenosine A 2A receptors, a subclass of purinergic receptors, resulting in the reduction of inflammation, and the stimulation of angiogenesis, collagen synthesis and the proliferation of a variety of cells such as osteoblasts, fibroblasts, pre-adipocytes and endothelial cells [2][3][4] . Owing to these properties, PDRN has been increasingly used as a bio-revitalizing agent for the regeneration of mucosa, bone, cartilage and tendon [5][6][7] . Additionally, numerous clinical researches have demonstrated substantial would-healing properties of PDRN 2,[8][9][10] .…”

Ischiofemoral impingement due to a lipoma of the ischiofemoral space

“…Conservative treatment is usually the first approach, with rest, restriction of the provoking activity, anti-inflammatory drugs and rehabilitation exercises. In cases with no improvement, ultrasound19 and CT14-guided corticosteroid injections or prolotherapy20 have been applied in a few patients, with promising results. Prolotherapy is recognised to offer some benefit in the management of osteoarthritis 21.…”

Extra-Articular Impingement: Ischiofemoral Impingement and Trochanteric-Pelvic

“…16 Ultrasound-guided prolotherapy consisting of 5 treatments at 1-2 weeks intervals with polydeoxyribonucleotide sodium has been reported to be successful in 2 patients, with subjects reporting long-term decrease in visual analog scale pain scores at 6 months following treatment. 17 The combination of physical therapy, activity modification, NSAIDs, and therapeutic injections has been successful in alleviating pain in most of the IFI cases. 9,18 Surgical Management Surgical management should be considered only after all nonsurgical measures have failed to provide relief and all other possible diagnoses have been excluded.…”