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Am J Sports Med. 2008 Jul;36(7):1347-57. doi: 10.1177/0363546508314431. Epub 2008 Feb 29.

Response of knee ligaments to prolotherapy in a rat injury model.

Author information

1
Department of Biomedical Engineering, University of Wisconsin, Madison, Wisconsin, USA.

Abstract

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.

PMID:
18310313
PMCID:
PMC3164307
DOI:
10.1177/0363546508314431
[Indexed for MEDLINE]
Free PMC Article

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