Article

OBJECTIVE: To determine the efficacy of prolotherapy for refractory rotator cuff
disease. DESIGN: Retrospective case-control study.
SETTING: University-affiliated
tertiary care hospital. PARTICIPANTS: Patients with nontraumatic refractory
rotator cuff disease (N=151) who were unresponsive to 3 months of aggressive
conservative treatment. Of the patients, 63 received prolotherapies with 16.5%
dextrose 10-ml solution (treatment group), and 63 continued conservative
treatment (control group). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES:
Visual analog scale (VAS) score of the average shoulder pain level for the past 1
week, Shoulder Pain and Disability Index (SPADI) score, isometric strength of the
shoulder abductor, active range of motion (AROM) of the shoulder, maximal tear
size on ultrasonography, and number of analgesic ingestions per day. RESULTS:
Over 1-year follow-up, 57 patients in the treatment group and 53 in the control
group were analyzed. There was no significant difference between the 2 groups in
age, sex, shoulder dominance, duration of symptoms, and ultrasonographic findings
at pretreatment. The average number of injections in the treatment group is
4.8+/-1.3. Compared with the control group, VAS score,
SPADI score, isometric
strength of shoulder abductor, and shoulder AROM of flexion, abduction, and
external rotation showed significant improvement in the treatment group. There
were no adverse events. CONCLUSIONS:
To our knowledge, this is the first study to
assess the efficacy of prolotherapy in rotator cuff disease. Prolotherapy showed
improvement in pain, disability, isometric strength, and shoulder AROM in
patients with refractory chronic rotator cuff disease.
The results suggest
positive outcomes, but one should still take caution in directly interpreting it
as an effective treatment option, considering the limitations of this
nonrandomized retrospective study. To show the efficacy of prolotherapy, further
studies on prospective randomized controlled trials will be required.
CI - Copyright (c) 2015 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS