Summary of Completed Research in Prolotherapy and Bioregenerative Injection K. Dean Reeves, M.D., Clinical Associate Professor, University of Kansas “This work is provided under the Creative Commons Attribution 3.0 Unported License.”
Explanation of Prolotherapy and Perineural Injection Therapy (Perineural Subcutaneous Injection and Perineural Deep Injection) Definition: Prolotherapy is an injection whose primary
Most state boards of medicine have definitions for what is experimental and what is not. Those definitions are based on two major issues. In general, if a procedure as taught by post graduate programs for the healing arts and has level II (out of IV) data in multiple areas, it is not considered experimental. Click to read more about why prolotherapy is not experimental.
Dextrose 25% Injection in chronic Achilles tendinopathy with 12-48 month follow-up results (2010) Ryan M, Wong A, Taunton J. Favorable outcomes after sonographically guided intratendinous injection of hyperosmolar dextrose for chronic insertional and midportion achilles tendinosis. Am J Roentgenol. 2010 Apr;194(4):1047-53. Dr. Reeves’ Notes: This study involved patients with chronic
Reeves KD Hassanein K Long term effects of dextrose prolotherapy for anterior cruciate ligament laxity: A prospective and consecutive patient study. Alt Ther Hlth Med May-Jun 2003, 9(3): p58-62. DEX: Reeves et al 2003 Dextrose Tightens Loose ACL Ligament by Simple Injection Dr. Reeves’ Notes: The “method” for this study
Centeno CJ; Schultz J; Freeman M. Sclerotherapy of Baker’s cyst with imaging confirmation of resolution. Pain Physician (United States), Mar-Apr 2008, 11(2) p257-61 Bakers Cyst: Dextrose + Sodium Morrhuate: Centeno 2008 Dr. Reeves’ Notes: This study demonstrated a case of MRI use to demonstrate shrinking of a Baker’s cyst by
Khan SA; Kumar A; Varshney MK; Trikha V; Yadav CS: Dextrose prolotherapy for recalcitrant coccygodynia J Orthop Surg , Apr 2008, 16(1) p27-9. Dex Khan et al 2008 Dr. Reeves’ Notes: This study related to chronic pain in coccyx (coccygodynia) after coccyx fracture. Treatment of coccygodynia after fracture was the
Miller et al 2006: Treatment of severely degenerative discs Treatment of painful advanced internal lumbar disc derangement with intradiscal injection of hypertonic dextrose. Miller MR, Mathews RS, Reeves KD. Pain Physician. 2006 Apr;9(2):115-21. Dr. Reeves’ Notes: Note that the great majority of the time the pain source is not the
Reeves KD, Hassanein K. Randomized prospective placebo controlled double blind study of dextrose prolotherapy for osteoarthritic thumbs and finger (DIP, PIP and Trapeziometacarpal) joints: Evidence of Clinical Efficacy. Jnl Alt Compl Med 2000;6(4):311-320. DEXTROSE PROLOTHERAPY FOR OSTEOARTHRITIC THUMBS AND FINGERDr. Reeves’ Notes: 10% dextrose superior to hypotonic lidocaine in finger
Regenerative Injection of Elite Athletes With Career-Altering Chronic Groin Pain Topol GA, Reeves KD: Regenerative injection of elite athletes with career-altering chronic groin pain who fail conservative treatment: a consecutive case series. Am J Phys Med Rehabil 2008;87; – . Dr. Reeves’ Notes: Dextrose 12.5% injection returns 66/72 elite rugby
One-Year Follow-Up on 15% dextrose outside and 25% dextrose inside the knee (2012) Hypertonic dextrose injections (prolotherapy) for knee osteoarthritis: results of a single-arm uncontrolled study with 1-year follow-up. J Altern Complement Med. 2012 Apr;18(4):408-14. Department of Family Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI
FOUNDATIONAL CONCEPTS 1. Needling of Tendons & Ligaments is NOT a Placebo: Puncture of Cell membrane With Inflammatory Lipid Release In the treatment of low back pain there are four treatment comparison studies. The control group in all back studies involved needle contact with attachments of ligaments and tendons. By
Fullerton BD. High-Resolution Ultrasound and Magnetic Resonance Imaging to Document Tissue Repair After Prolotherapy Arch PM&R 2008. 89(2):377-385 HEALING OF A MEDIAL MENISCUS TEAR (2007) DR. REEVES’ NOTES: The medial meniscus of the knee is non linear structure. Dr. Fullerton published examples of regeneration from dextrose injection, including an example
Centeno CJ, Elliott J, Elkins WL, Freeman M. Fluoroscopically Guided Cervical Prolotherapy for with Blinded Pre and Post Radiographic Reading Pain Physician. 2005;8:67-72. DEXTROSE: Centeno et al 2005. Reduction in laxity demonstrated by radiographic imaging. DR. REEVES’ NOTES: This is a very small but intriguing case series looking at flexion
INTRODUCTION Osgood Schlatter’s Disease (OSD) is very common in young adolescents, affecting millions of young people a year, and represents damage to the tendon to cartilage connection on the bony prominence just below the knee cap. If it does not respond quickly to sports limitation, it often leads to substantial
Ultrasound-guided injections of hyperosmolar dextrose for overuse patellar tendinopathy (2011) Ryan M; Wong A; Rabago D; Lee K; Taunton J. Ultrasound-guided injections of hyperosmolar dextrose for overuse patellar tendinopathy: a pilot study [In Process Citation] Br J Sports Med 2011; 45(12):972-7. DR. REEVES’ NOTES: Chronic infrapatellar tendinopathy presents a challenge
Dextrose: Ryan et al 2009 Dextrose injection for chronic pain of Plantar fasciosis Ryan MB, Wong AD, Gillies JH, Wong J, Traunton JE Sonographically guided intratendinous injections of hyperosmolar dextrose/lidocaine: a pilot study for the treatment of chronic plantar fasciitis. Br J Sports Med 2009;43 :303–306. DR. REEVES’ NOTES: The
Cusi M; Saunders J; Hungerford B; Wisbey-Roth T; Lucas P; Wilson S. The use of prolotherapy in the sacroiliac joint. Br J Sports Med 2010;44: 100-104. DEXTROSE: CUSI ET AL 2008: DEXTROSE INJECTION MARKEDLY IMPROVES LAXITY TESTING OF THE SI JOINT. DR. REEVES’ NOTES: Twenty-five consecutive patients with chronic low
Curtin M, Crisp T, Malliaras P, Padhiar N. The effectiveness of prolotherapy in the management of recalcitrant medial tibial stress syndrome: a pilot study. Br J Sports Med 2011;45:e1 doi:10.1136/bjsm.2010.081554.8 PILOT STUDY ON RECALCITRANT SHIN SPLINTS DR. REEVES’ NOTES: Dr. Reeves’ Notes: Shin splints or medial tibial stress syndrome (MTSS)
Ongoing Positive Effect of Platelet-Rich Plasma Versus Corticosteroid Injection (2011) Gosens T, Peerbooms JC, van Laar W, den Oudsten BL. Ongoing Positive Effect of Platelet-Rich Plasma Versus Corticosteroid Injection in Lateral Epicondylitis: A Double-Blind Randomized Controlled Trial With 2-year Follow-up [In Process Citation] Am J Sports Med (United States), Jun
Refai H, Altahhan O, Elsharkawy R.[Epub ahead of print] The Efficacy of Dextrose Prolotherapy for Temporomandibular Joint Hypermobility: A Preliminary Prospective, Randomized, Double-Blind, Placebo-Controlled Clinical Trial. Oral Maxillofac Surg. 2011 Jul 12. THE EFFICACY OF DEXTROSE PROLOTHERAPY FOR TEMPOROMANDIBULAR JOINT HYPERMOBILITY (2011) DR. REEVES’ NOTES: A study on dextrose prolotherapy