Long-term effects of dextrose prolotherapy for anterior cruciate ligament laxity.
BACKGROUND
Use of dextrose prolotherapy. Prolotherapy is defined as injection that causes growth of normal cells or tissue.


OBJECTIVE
Determine the 1 and 3 year efficacy of dextrose injection prolotherapy on anterior cruciate ligament (ACL) laxity. After year 1, determine patient tolerance of a stronger dextrose concentration (25% versus 10%).


METHODS
Prospective consecutive patient trial.


METHODS
Outpatient physical medicine clinic.


METHODS
Eighteen patients with 6 months or more of knee pain plus ACL knee laxity. This laxity was defined by a KT1000 anterior displacement difference (ADD) of 2 mm or more.


METHODS
Intraarticular injection of 6-9 cc of 10% dextrose at months 0, 2, 4, 6, and 10. Injection with 6 cc of 25% dextrose at 12 months. Then, depending on patient preference, injection of either 10% or 25% dextrose every 2-4 months (based on patient preference) through 36 months.


METHODS
Visual analogue scale (VAS) for pain at rest, pain on level surfaces, pain on stairs, and swelling. Goniometric flexion range of motion, and KT1000-measured ADD were also measured. All measurements were obtained at 0, 6, 12 and 36 months.


RESULTS
Two patients did not reach 6 month data collection, 1 of whom was diagnosed with disseminated cancer. The second was wheelchair-bound and found long-distance travel to the clinic problematic. Sixteen subjects were available for data analysis. KT1000 ADD, measurement indicated that 6 knees measured as normal (not loose) after 6 months, 9 measured as normal after 1 year (6 injections), and 10 measured as normal at 3 years. At the 3 year follow-up, pain at rest, pain with walking, and pain with stair use had improved by 45%, 43%, and 35% respectively. Individual paired t tests indicated subjective swelling improved 63% (P = .017), flexion range of motion improved by 10.5 degrees (P = .002), and KT1000 ADD improved by 71% (P = .002). Eleven out of 16 patients preferred 10% dextrose injection.


CONCLUSIONS
In patients with symptomatic anterior cruciate ligament laxity, intermittent dextrose injection resulted in clinically and statistically significant improvement in ACL laxity, pain, swelling, and knee range of motion.
Reeves
K Dean
KD
Department of Biometry, University of Kansas Medical Center, Kansas City, Kan., USA.
Hassanein
Khatab M
KM
D000368:Aged; D016118:Anterior Cruciate Ligament / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D005947:Glucose / Q000008:administration & dosage*; D006133:Growth Substances / Q000008:administration & dosage*; D006705:Homeopathy / Q000379:methods; D006801:Humans; D007270:Injections, Intra-Articular; D007593:Joint Instability / Q000188:drug therapy* / Q000503:physiopathology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000188:drug therapy* / Q000503:physiopathology; D010147:Pain Measurement; D011446:Prospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D016138:Walking
D006133:Growth Substances; D005947:Glucose