Research Article
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Parsiyel ön çapraz bağ yırtığı olan hastalarda %5 dekstroz proloterapisinin etkinliğinin değerlendirilmesi

Year 2025, Volume: 16 Issue: 3, 432 - 438, 30.09.2025
https://doi.org/10.18663/tjcl.1710550

Abstract

Amaç: Proloterapi, kas-iskelet yaralanmalarının iyileşmesini desteklemeyi amaçlayan rejeneratif bir enjeksiyon tedavisidir. Bu çalışma, ön çapraz bağ (ACL) yırtıkları olan hastalarda %5 dekstroz proloterapisinin ağrı seviyeleri ve fonksiyonel kapasite üzerindeki etkinliğini değerlendirmeyi amaçlamaktadır.
Gereç ve Yöntemler: Bu retrospektif çalışmaya, yaş ve cinsiyete göre 1:1 eşleştirilmiş iki gruba ayrılmış 60 ACL yırtıkları olan hasta dahil edildi. Proloterapi grubu (n = 30) altı seans boyunca aylık %5 dekstroz solüsyonu enjeksiyonları alırken, kontrol grubu (n = 30) sadece fizik tedavi gördü. Ağrı yoğunluğu Görsel Analog Skala (VAS) kullanılarak değerlendirildi ve fonksiyonel sonuçlar başlangıçta ve 3. ve 6. tedavi seanslarından sonra Alt Ekstremite Fonksiyonel Skalası (LEFS) ile ölçüldü.
Bulgular: İki grup arasında temel demografik ve klinik özellikler benzerdi. Üçüncü seansta, proloterapi grubu kontrol grubuna kıyasla önemli ölçüde azalmış ağrı gösterdi (VAS: 5,2 ± 1,1'e karşı 7,9 ± 0,9; p < 0,001). Altıncı seansta, proloterapi grubunda kontrol grubuna kıyasla daha da önemli ağrı azalması gözlemlendi (VAS: 2,8 ± 1,2'ye karşı 7,3 ± 1,0; p < 0,001). Proloterapi grubunda fonksiyonel kapasite, kontrol grubuna kıyasla altıncı seansta önemli ölçüde iyileşti (LEFS: 68,6 ± 8,5'e karşı 52,4 ± 7,3; p < 0,001).
Sonuç: %5 dekstroz proloterapisi uygulaması, ACL yırtıkları olan hastalarda ağrıyı önemli ölçüde azalttı ve fonksiyonel kapasiteyi iyileştirdi. Proloterapi, dizdeki bağ yaralanmaları için etkili bir minimal invaziv tedavi seçeneği olarak hizmet edebilir.

Ethical Statement

Çalışma Helsinki Bildirgesi’ne uygun olarak yürütüldü ve Sağlık Bilimleri Üniversitesi, SBÜ Gülhane Eğitim ve Araştırma Hastanesi GETAT Klinik Araştırmalar Etik Kurulu’ndan onay alındı ​​(Tarih: 05.02.2025, Karar No: 2025/2).

References

  • MacAuley D. Ankle injuries: same joint, different sports. Med Sci Sports Exerc 1999; 31(7 Suppl): S409-11.
  • Jung HJ, Fisher MB, Woo SL. Role of biomechanics in the understanding of normal, injured, and healing ligaments and tendons. Sports Med Arthrosc Rehabil Ther Technol 2009; 1: 9.
  • Bunt CW, Jonas CE, and Chang JG. Knee Pain in Adults and Adolescents: The Initial Evaluation. Am Fam Physician 2018; 98: 576-85.
  • Nguyen US, Zhang Y, Zhu Y, Niu J, Zhang B, and Felson DT. Increasing prevalence of knee pain and symptomatic knee osteoarthritis: survey and cohort data. Ann Intern Med 2011; 155: 725-32.
  • Wheaton MT, Jensen N. The Ligament Injury-Osteoarthritis Connection: The Role of Prolotherapy in Ligament Repair. J Prolother 2011; 3: 790-812.
  • Torgutalp ŞŞ, Dönmez G, Korkusuz F. Incidence rates of injuries associated with anterior cruciate ligament tear diagnosed by magnetic resonance imaging: A retrospective cohort study. Spor Hekimliği Dergisi 2021; 56: 033-37.
  • Hauser RA, Lackner JB, Steilen-Matias D, Harris DK. A Systematic Review of Dextrose Prolotherapy for Chronic Musculoskeletal Pain. Clin Med Insights Arthritis Musculoskelet Disord 2016; 9: 139-59.
  • Rabago D, Slattengren A, Zgierska A. Prolotherapy in primary care practice. Prim Care 2010; 37: 65-80.
  • Zhou L, Liang H, Chen Y, Hu K, Liu X. Dextrose prolotherapy at varying concentrations ameliorates tendon injury via IGF-2R: an integrated study of Mendelian randomization and an animal model. J Orthop Surg Res 2025; 20: 556.
  • Oh S, Ettema AM, Zhao C, et al. Dextrose-induced subsynovial connective tissue fibrosis in the rabbit carpal tunnel: A potential model to study carpal tunnel syndrome? Hand (N Y). 2008; 3: 34-40.
  • Dagenais S, Yelland MJ, Del Mar C, Schoene ML. Prolotherapy injections for chronic low-back pain. Cochrane Database Syst Rev 2007; 2007: CD004059.
  • Jensen KT, Rabago DP, Best TM, Patterson JJ, Vanderby R, Jr. Response of knee ligaments to prolotherapy in a rat injury model. Am J Sports Med 2008; 36: 1347-57.
  • Austin PC. Optimal caliper widths for propensity-score matching when estimating differences in means and differences in proportions in observational studies. Pharm Stat 2011; 10: 150-61.
  • Van Pelt RS. Prolotherapy Technique on Injecting the Anterior Cruciate Ligament. J Prolother 2009; 1: 36-38.
  • Binkley JM, Stratford PW, Lott SA, Riddle DL. The Lower Extremity Functional Scale (LEFS): scale development, measurement properties, and clinical application. North American Orthopaedic Rehabilitation Research Network. Phys Ther 1999; 79: 371-83.
  • Reeves KD and Hassanein K. Randomized prospective double-blind placebo-controlled study of dextrose prolotherapy for knee osteoarthritis with or without ACL laxity. Altern Ther Health Med 2000; 6: 68-74, 77-80.
  • Reeves KD, Hassanein KM. Long-term effects of dextrose prolotherapy for anterior cruciate ligament laxity. Altern Ther Health Med 2003; 9: 58-62.
  • Reeves KD, Sit RW, Rabago DP. Dextrose Prolotherapy: A Narrative Review of Basic Science, Clinical Research, and Best Treatment Recommendations. Phys Med Rehabil Clin N Am 2016; 27: 783-823.
  • Hauser R, Blakemore P, Wang J, Steilen D. Structural basis of joint instability as cause for chronic musculoskeletal pain and its successful treatment with regenerative injection therapy (prolotherapy). Open Pain J 2014; 7: 9-22.
  • Freeman JW, Empson YM, Ekwueme EC, Paynter DM, Brolinson PG. Effect of prolotherapy on cellular proliferation and collagen deposition in MC3T3-E1 and patellar tendon fibroblast populations. Transl Res 2011; 158: 132-9.
  • Jensen KT, Rabago DP, Best TM, Patterson JJ, Vanderby R, Jr. Early inflammatory response of knee ligaments to prolotherapy in a rat model. J Orthop Res 2008; 26: 816-23.
  • Martins CA, Bertuzzi RT, Tisot RA, et al. Dextrose prolotherapy and corticosteroid injection into rat Achilles tendon. Knee Surg Sports Traumatol Arthrosc 2012; 20: 1895-900.
  • Köroğlu Ö, Örsçelik A, Karasimav Ö, Demir Y, Solmaz İ. Is 5% dextrose prolotherapy effective for radicular low back pain? Gülhane Tip Dergisi 2019; 61: 123-27.
  • Rabago D and Nourani B. Prolotherapy for Osteoarthritis and Tendinopathy: a Descriptive Review. Curr Rheumatol Rep 2017; 19: 34.
  • Kazempour Mofrad M, Rezasoltani Z, Dadarkhah A, Hamidi Panah S, Tabatabaee SM, Azarakhsh A. Neurofascial Dextrose Prolotherapy for Managing Chronic Ankle Ligament Injury. Anesth Pain Med 2022; 12: e118317.
  • Ciftci YGD, Tuncay F, Kocak FA, Okcu M. Is Low-Dose Dextrose Prolotherapy as Effective as High-Dose Dextrose Prolotherapy in the Treatment of Lateral Epicondylitis? A Double-Blind, Ultrasound Guided, Randomized Controlled Study. Arch Phys Med Rehabil 2023; 104: 179-87.
  • Nair LS. Prolotherapy for tissue repair. Transl Res 2011; 158: 129-31.
  • Rabago D, Best TM, Beamsley M, Patterson J. A systematic review of prolotherapy for chronic musculoskeletal pain. Clin J Sport Med 2005; 15: 376-80.
  • Capotosto S, Nazemi AK, Komatsu DE, Penna J. Prolotherapy in the Treatment of Sports-Related Tendinopathies: A Systematic Review of Randomized Controlled Trials. Orthop J Sports Med 2024; 12: 23259671241275087.
  • Sanderson LM, Bryant A. Effectiveness and safety of prolotherapy injections for management of lower limb tendinopathy and fasciopathy: a systematic review. J Foot Ankle Res 2015; 8: 57.
  • Sağlam S, Aydın M, Yüzügüldü U, Erşen Ö, Uludağ V. The Effect of Prolotherapy and Dry Needling on Pain and Foot Functions in Hallux Valgus. Duzce Medical Journal 2024; 26:1 18-21.
  • Chung MW, Hsu CY, Chung WK, Lin YN. Effects of dextrose prolotherapy on tendinopathy, fasciopathy, and ligament injuries, fact or myth?: A systematic review and meta-analysis. Medicine (Baltimore). 2020; 99: e23201.
  • Sit RWS, Wu RWK, Ling SKK, et al. A protocol for a randomized clinical trial assessing the efficacy of hypertonic dextrose injection (prolotherapy) in chronic ankle instability. Trials 2022; 23: 1063.

Assessing the efficacy of 5% dextrose prolotherapy in patients with partial anterior cruciate ligament tears

Year 2025, Volume: 16 Issue: 3, 432 - 438, 30.09.2025
https://doi.org/10.18663/tjcl.1710550

Abstract

Aim: Prolotherapy is a regenerative injection treatment aimed at promoting the healing of musculoskeletal injuries. This study aimed to evaluate the effectiveness of 5% dextrose prolotherapy on pain levels and functional capacity in patients with partial anterior cruciate ligament (ACL) injuries.
Materials and Methods: This retrospective study reviewed medical records of 60 patients with partial ACL tears who were matched 1:1 based on age and sex into two groups: a prolotherapy group (n = 30), who had received monthly injections of 5% dextrose solution for six sessions, and a control group (n=30), who had undergone physical therapy alone. Pain intensity was retrospectively assessed using the Visual Analog Scale (VAS), and functional outcomes were evaluated using the Lower Extremity Functional Scale (LEFS) from baseline records and after the 3rd and 6th treatment sessions.
Results: Baseline demographic and clinical characteristics were similar between the two groups. By the third session, the prolotherapy group showed significantly reduced pain compared to the control group (VAS: 5.2 ± 1.1 vs. 7.9 ± 0.9, p < 0.001). By the sixth session, further significant pain reduction was observed in the prolotherapy group compared to controls (VAS: 2.8 ± 1.2 vs. 7.3 ± 1.0, p < 0.001). Functional capacity significantly improved in the prolotherapy group by the sixth session compared to the control group (LEFS: 68.6 ± 8.5 vs. 52.4 ± 7.3, p < 0.001).
Conclusion: Administration 5% dextrose prolotherapy significantly reduced pain and improved functional capacity in patients with ACL tears. Prolotherapy may serve as an effective minimally invasive treatment option for ligamentous injuries of the knee.

Ethical Statement

The study was performed in accordance with the Declaration of Helsinki, and was approved by the Health Sciences University, SBU Gulhane Training and Research Hospital GETAT Clinical Research Ethics Committee (Date: 05.02.2025, Decision No: 2025/2).

References

  • MacAuley D. Ankle injuries: same joint, different sports. Med Sci Sports Exerc 1999; 31(7 Suppl): S409-11.
  • Jung HJ, Fisher MB, Woo SL. Role of biomechanics in the understanding of normal, injured, and healing ligaments and tendons. Sports Med Arthrosc Rehabil Ther Technol 2009; 1: 9.
  • Bunt CW, Jonas CE, and Chang JG. Knee Pain in Adults and Adolescents: The Initial Evaluation. Am Fam Physician 2018; 98: 576-85.
  • Nguyen US, Zhang Y, Zhu Y, Niu J, Zhang B, and Felson DT. Increasing prevalence of knee pain and symptomatic knee osteoarthritis: survey and cohort data. Ann Intern Med 2011; 155: 725-32.
  • Wheaton MT, Jensen N. The Ligament Injury-Osteoarthritis Connection: The Role of Prolotherapy in Ligament Repair. J Prolother 2011; 3: 790-812.
  • Torgutalp ŞŞ, Dönmez G, Korkusuz F. Incidence rates of injuries associated with anterior cruciate ligament tear diagnosed by magnetic resonance imaging: A retrospective cohort study. Spor Hekimliği Dergisi 2021; 56: 033-37.
  • Hauser RA, Lackner JB, Steilen-Matias D, Harris DK. A Systematic Review of Dextrose Prolotherapy for Chronic Musculoskeletal Pain. Clin Med Insights Arthritis Musculoskelet Disord 2016; 9: 139-59.
  • Rabago D, Slattengren A, Zgierska A. Prolotherapy in primary care practice. Prim Care 2010; 37: 65-80.
  • Zhou L, Liang H, Chen Y, Hu K, Liu X. Dextrose prolotherapy at varying concentrations ameliorates tendon injury via IGF-2R: an integrated study of Mendelian randomization and an animal model. J Orthop Surg Res 2025; 20: 556.
  • Oh S, Ettema AM, Zhao C, et al. Dextrose-induced subsynovial connective tissue fibrosis in the rabbit carpal tunnel: A potential model to study carpal tunnel syndrome? Hand (N Y). 2008; 3: 34-40.
  • Dagenais S, Yelland MJ, Del Mar C, Schoene ML. Prolotherapy injections for chronic low-back pain. Cochrane Database Syst Rev 2007; 2007: CD004059.
  • Jensen KT, Rabago DP, Best TM, Patterson JJ, Vanderby R, Jr. Response of knee ligaments to prolotherapy in a rat injury model. Am J Sports Med 2008; 36: 1347-57.
  • Austin PC. Optimal caliper widths for propensity-score matching when estimating differences in means and differences in proportions in observational studies. Pharm Stat 2011; 10: 150-61.
  • Van Pelt RS. Prolotherapy Technique on Injecting the Anterior Cruciate Ligament. J Prolother 2009; 1: 36-38.
  • Binkley JM, Stratford PW, Lott SA, Riddle DL. The Lower Extremity Functional Scale (LEFS): scale development, measurement properties, and clinical application. North American Orthopaedic Rehabilitation Research Network. Phys Ther 1999; 79: 371-83.
  • Reeves KD and Hassanein K. Randomized prospective double-blind placebo-controlled study of dextrose prolotherapy for knee osteoarthritis with or without ACL laxity. Altern Ther Health Med 2000; 6: 68-74, 77-80.
  • Reeves KD, Hassanein KM. Long-term effects of dextrose prolotherapy for anterior cruciate ligament laxity. Altern Ther Health Med 2003; 9: 58-62.
  • Reeves KD, Sit RW, Rabago DP. Dextrose Prolotherapy: A Narrative Review of Basic Science, Clinical Research, and Best Treatment Recommendations. Phys Med Rehabil Clin N Am 2016; 27: 783-823.
  • Hauser R, Blakemore P, Wang J, Steilen D. Structural basis of joint instability as cause for chronic musculoskeletal pain and its successful treatment with regenerative injection therapy (prolotherapy). Open Pain J 2014; 7: 9-22.
  • Freeman JW, Empson YM, Ekwueme EC, Paynter DM, Brolinson PG. Effect of prolotherapy on cellular proliferation and collagen deposition in MC3T3-E1 and patellar tendon fibroblast populations. Transl Res 2011; 158: 132-9.
  • Jensen KT, Rabago DP, Best TM, Patterson JJ, Vanderby R, Jr. Early inflammatory response of knee ligaments to prolotherapy in a rat model. J Orthop Res 2008; 26: 816-23.
  • Martins CA, Bertuzzi RT, Tisot RA, et al. Dextrose prolotherapy and corticosteroid injection into rat Achilles tendon. Knee Surg Sports Traumatol Arthrosc 2012; 20: 1895-900.
  • Köroğlu Ö, Örsçelik A, Karasimav Ö, Demir Y, Solmaz İ. Is 5% dextrose prolotherapy effective for radicular low back pain? Gülhane Tip Dergisi 2019; 61: 123-27.
  • Rabago D and Nourani B. Prolotherapy for Osteoarthritis and Tendinopathy: a Descriptive Review. Curr Rheumatol Rep 2017; 19: 34.
  • Kazempour Mofrad M, Rezasoltani Z, Dadarkhah A, Hamidi Panah S, Tabatabaee SM, Azarakhsh A. Neurofascial Dextrose Prolotherapy for Managing Chronic Ankle Ligament Injury. Anesth Pain Med 2022; 12: e118317.
  • Ciftci YGD, Tuncay F, Kocak FA, Okcu M. Is Low-Dose Dextrose Prolotherapy as Effective as High-Dose Dextrose Prolotherapy in the Treatment of Lateral Epicondylitis? A Double-Blind, Ultrasound Guided, Randomized Controlled Study. Arch Phys Med Rehabil 2023; 104: 179-87.
  • Nair LS. Prolotherapy for tissue repair. Transl Res 2011; 158: 129-31.
  • Rabago D, Best TM, Beamsley M, Patterson J. A systematic review of prolotherapy for chronic musculoskeletal pain. Clin J Sport Med 2005; 15: 376-80.
  • Capotosto S, Nazemi AK, Komatsu DE, Penna J. Prolotherapy in the Treatment of Sports-Related Tendinopathies: A Systematic Review of Randomized Controlled Trials. Orthop J Sports Med 2024; 12: 23259671241275087.
  • Sanderson LM, Bryant A. Effectiveness and safety of prolotherapy injections for management of lower limb tendinopathy and fasciopathy: a systematic review. J Foot Ankle Res 2015; 8: 57.
  • Sağlam S, Aydın M, Yüzügüldü U, Erşen Ö, Uludağ V. The Effect of Prolotherapy and Dry Needling on Pain and Foot Functions in Hallux Valgus. Duzce Medical Journal 2024; 26:1 18-21.
  • Chung MW, Hsu CY, Chung WK, Lin YN. Effects of dextrose prolotherapy on tendinopathy, fasciopathy, and ligament injuries, fact or myth?: A systematic review and meta-analysis. Medicine (Baltimore). 2020; 99: e23201.
  • Sit RWS, Wu RWK, Ling SKK, et al. A protocol for a randomized clinical trial assessing the efficacy of hypertonic dextrose injection (prolotherapy) in chronic ankle instability. Trials 2022; 23: 1063.
There are 33 citations in total.

Details

Primary Language English
Subjects Pain
Journal Section Research Article
Authors

İlker Solmaz 0000-0002-1959-8159

Publication Date September 30, 2025
Submission Date May 31, 2025
Acceptance Date July 21, 2025
Published in Issue Year 2025 Volume: 16 Issue: 3

Cite

APA Solmaz, İ. (2025). Assessing the efficacy of 5% dextrose prolotherapy in patients with partial anterior cruciate ligament tears. Turkish Journal of Clinics and Laboratory, 16(3), 432-438. https://doi.org/10.18663/tjcl.1710550
AMA Solmaz İ. Assessing the efficacy of 5% dextrose prolotherapy in patients with partial anterior cruciate ligament tears. TJCL. September 2025;16(3):432-438. doi:10.18663/tjcl.1710550
Chicago Solmaz, İlker. “Assessing the Efficacy of 5% Dextrose Prolotherapy in Patients With Partial Anterior Cruciate Ligament Tears”. Turkish Journal of Clinics and Laboratory 16, no. 3 (September 2025): 432-38. https://doi.org/10.18663/tjcl.1710550.
EndNote Solmaz İ (September 1, 2025) Assessing the efficacy of 5% dextrose prolotherapy in patients with partial anterior cruciate ligament tears. Turkish Journal of Clinics and Laboratory 16 3 432–438.
IEEE İ. Solmaz, “Assessing the efficacy of 5% dextrose prolotherapy in patients with partial anterior cruciate ligament tears”, TJCL, vol. 16, no. 3, pp. 432–438, 2025, doi: 10.18663/tjcl.1710550.
ISNAD Solmaz, İlker. “Assessing the Efficacy of 5% Dextrose Prolotherapy in Patients With Partial Anterior Cruciate Ligament Tears”. Turkish Journal of Clinics and Laboratory 16/3 (September2025), 432-438. https://doi.org/10.18663/tjcl.1710550.
JAMA Solmaz İ. Assessing the efficacy of 5% dextrose prolotherapy in patients with partial anterior cruciate ligament tears. TJCL. 2025;16:432–438.
MLA Solmaz, İlker. “Assessing the Efficacy of 5% Dextrose Prolotherapy in Patients With Partial Anterior Cruciate Ligament Tears”. Turkish Journal of Clinics and Laboratory, vol. 16, no. 3, 2025, pp. 432-8, doi:10.18663/tjcl.1710550.
Vancouver Solmaz İ. Assessing the efficacy of 5% dextrose prolotherapy in patients with partial anterior cruciate ligament tears. TJCL. 2025;16(3):432-8.