BACKGROUND: Prolotherapy is an alternative therapy for chronic musculoskeletal injury including joint laxity. The commonly used injectant, D-glucose (dextrose), is hypothesized to improve ligament mechanics and decrease pain through an inflammatory mechanism. No study has investigated the mechanical effects of prolotherapy on stretch-injured ligaments. HYPOTHESES: Dextrose injections will enlarge cross-sectional area, decrease laxity, strengthen, and stiffen stretch-injured medial collateral ligaments (MCLs) compared with controls. Dextrose prolotherapy will increase collagen fibril diameter and density of stretch-injured MCLs. STUDY DESIGN: Controlled laboratory study. METHODS: Twenty-four rats were bilaterally MCL stretch-injured, and the induced laxity was measured. After 2 weeks, 32 MCLs were injected twice, 1 week apart, with either dextrose or saline control; 16 MCLs received no injection. Seven uninjured rats (14 MCLs) were additional controls. Two weeks after the second injection, ligament laxity, mechanical properties (n = 8), and collagen fibril diameter and density (n = 3) were assessed. RESULTS: The injury model created consistent ligament laxity (P < .05) that was not altered by dextrose injections. Cross-sectional area of dextrose-injected MCLs was increased 30% and 90% compared with saline and uninjured controls, respectively (P < .05). Collagen fibril diameter and density were decreased in injured ligaments compared with uninjured controls (P < .05), but collagen fibril characteristics were not different between injured groups. CONCLUSION: Dextrose injections increased the cross-sectional area of MCLs compared with saline-injected and uninjured controls. Dextrose injections did not alter other measured properties in this model. CLINICAL RELEVANCE: Our results suggest that clinical improvement from prolotherapy may not result from direct effects on ligament biomechanics.
BACKGROUND: Prolotherapy is an alternative therapy for chronic musculoskeletal injury including joint laxity. The commonly used injectant, D-glucose (dextrose), is hypothesized to improve ligament mechanics and decrease pain through an inflammatory mechanism. No study has investigated the mechanical effects of prolotherapy on stretch-injured ligaments. HYPOTHESES: Dextrose injections will enlarge cross-sectional area, decrease laxity, strengthen, and stiffen stretch-injured medial collateral ligaments (MCLs) compared with controls. Dextrose prolotherapy will increase collagen fibril diameter and density of stretch-injured MCLs. STUDY DESIGN: Controlled laboratory study. METHODS: Twenty-four rats were bilaterally MCL stretch-injured, and the induced laxity was measured. After 2 weeks, 32 MCLs were injected twice, 1 week apart, with either dextrose or saline control; 16 MCLs received no injection. Seven uninjured rats (14 MCLs) were additional controls. Two weeks after the second injection, ligament laxity, mechanical properties (n = 8), and collagen fibril diameter and density (n = 3) were assessed. RESULTS: The injury model created consistent ligament laxity (P < .05) that was not altered by dextrose injections. Cross-sectional area of dextrose-injected MCLs was increased 30% and 90% compared with saline and uninjured controls, respectively (P < .05). Collagen fibril diameter and density were decreased in injured ligaments compared with uninjured controls (P < .05), but collagen fibril characteristics were not different between injured groups. CONCLUSION:Dextrose injections increased the cross-sectional area of MCLs compared with saline-injected and uninjured controls. Dextrose injections did not alter other measured properties in this model. CLINICAL RELEVANCE: Our results suggest that clinical improvement from prolotherapy may not result from direct effects on ligament biomechanics.
Authors: Michael Scarpone; David P Rabago; Aleksandra Zgierska; Gennie Arbogast; Edward Snell Journal: Clin J Sport Med Date: 2008-05 Impact factor: 3.638
Authors: Michael J Yelland; Paul P Glasziou; Nikolai Bogduk; Philip J Schluter; Mary McKernon Journal: Spine (Phila Pa 1976) Date: 2004-01-01 Impact factor: 3.468
Authors: D T Felson; R C Lawrence; P A Dieppe; R Hirsch; C G Helmick; J M Jordan; R S Kington; N E Lane; M C Nevitt; Y Zhang; M Sowers; T McAlindon; T D Spector; A R Poole; S Z Yanovski; G Ateshian; L Sharma; J A Buckwalter; K D Brandt; J F Fries Journal: Ann Intern Med Date: 2000-10-17 Impact factor: 25.391
Authors: David Rabago; Richard Kijowski; Michael Woods; Jeffrey J Patterson; Marlon Mundt; Aleksandra Zgierska; Jessica Grettie; John Lyftogt; Luke Fortney Journal: Arch Phys Med Rehabil Date: 2013-07-10 Impact factor: 3.966
Authors: David Rabago; Aleksandra Zgierska; Luke Fortney; Richard Kijowski; Marlon Mundt; Michael Ryan; Jessica Grettie; Jeffrey J Patterson Journal: J Altern Complement Med Date: 2012-04 Impact factor: 2.579
Authors: Emmanuel C Ekwueme; Mahir Mohiuddin; Jazmin A Yarborough; P Gunnar Brolinson; Denitsa Docheva; Hugo A M Fernandes; Joseph W Freeman Journal: Clin Orthop Relat Res Date: 2017-04-27 Impact factor: 4.176
Authors: Yuichi Yoshii; Chunfeng Zhao; James D Schmelzer; Phillip A Low; Kai-Nan An; Peter C Amadio Journal: J Orthop Res Date: 2011-01-18 Impact factor: 3.494