• The Korean Journal of Pain
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• v.22 no.3
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• pp.229-233
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• 2009

Background: Sacroiliac (SI) joint pain is a challenging condition that causes lower back or buttock pain; however, there is no universally accepted long-term treatment. There have been several reports of ligament prolotherapy for SI joint pain, but these have had inconsistent results, probably due to the lack of a specific diagnosis for patient selection and variability in the volume, number and sites of injection. Therefore, this study was conducted to assess the efficacy of intraarticular prolotherapy for relieving SI joint pain diagnosed by local anesthetic intraarticular injection. Methods: Twenty-two patients with SI joint pain confirmed by 50% or more improvement in response to local anesthetic block underwent intraarticular prolotherapy with 25% dextrose water every other week three times. The numeric rating scale (NRS) for pain and Oswestry disability index (ODI) were assessed at the initial visit and after completion of a series of prolotherapy and the NRS was checked during monthly follow-up sessions to evaluate the long-term effectiveness of this technique. Results: Twenty patients completed prolotherapy and followed up as scheduled. The NRS and ODI were significantly improved from 6 (4-8) and $34.1{\pm}15.5$ to 1 (0-3) and $12.6{\pm}9.8$ (P < 0.01), respectively, at 1 month after prolotherapy. The mean duration of pain relief of 50% or more was 12.2 months (95% CI, 10.0-14.3) as determined by Kaplan-Meier survival analysis. Conclusions: Intraarticular prolotherapy provided long-term relief of sacroiliac joint pain and may have more benefits than ligament prolotherapy or neurolysis.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.2 no.1
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• pp.37-44
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• 2009

Prolotherapy, the technology for strengthening lax ligaments, has found increased acceptance in recent years. Prolotherapy involves the injection of the irritant solutions into the weakened or stretched ligaments which are a source of chronic pain. This induces an inflammatory response which mimics the normal repair sequence. Various musculoskeletal disorders of lower extremities such as degenerative arthrtitis, ligament and tendon injuries can be treated with prolotherapy. Prolotherapy is a very good, powerful nonsurgical conservative treatment in various musculoskeletal disorders. Ultrasound exam is very useful to find and confirm the exact location of disorders and check the progress in prolotherapy practices.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.48 no.1
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• pp.33-40
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• 2022

Objectives: Prolotherapy is a method that has gained popularity in recent years and has been reported to have positive short-term and long-term clinical results in maxillofacial surgery, especially temporomandibular joint (TMJ) hypermobility. This study aimed to evaluate the changes in the trabecular structure of mandibular condyles in patients who underwent prolotherapy due to TMJ hypermobility using the fractal analysis method. Materials and Methods: Forty-five patients who received dextrose prolotherapy at a concentration of 20% and fifteen control patients were included in the study. All patients had panoramic radiographs just before (T0) and six months after treatment (T1). The patients who received treatment were divided into three groups according to the number of prolotherapy injections. The regions of interest were selected from bone areas close to the articular surfaces of the condyles. The fractal dimension (FD) values were calculated. Results: The main effect of time on the FD value was significant [F (1, 56)=86.176, P<0.001]. This effect was qualified by a significant time×group interaction effect [F (3, 56)=9.023, P<0.001]. The decreases in FD values in all treatment groups between T0 and T1 times were significant (P=0.004). However, changes in FD values were not significant in the control group (P=0.728). Conclusion: Dextrose prolotherapy without the effect of the number of injections caused a decrease in FD values in the mandibular condyles over time.

• The Korean Journal of Pain
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• v.14 no.1
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• pp.114-117
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• 2001

A significant injury of ligament or tendon that might result in hypermobility and/or instability has been termed connective tissue insufficiency (CTI). Load bearing on CTI can sometimes create a malfunction of the mechanoreceptor and this in turn can aggravate the problem thus creating a chronic condition. Prolotherapy means the injection of growth factors or growth factor stimulators into the fibroosseous junction of the disabled ligament, tendon or cartilages in order to strengthen and promote proliferation of the injured Connective tissue. In the case of frequent recurrence or unresponsiveness to conservative treatment including nerve blocks in the chronic musculoskeletal disorder. We obtained good results after the prolotherapy treatment. This study will report on 5 cases of prolotherapy treatment.

• Journal of the Korean Orthopaedic Association
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• v.54 no.5
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• pp.469-473
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• 2019

Medial knee joint pain is a common problem in the field of orthopedics. In these patients, a high resolution ultrasound examination can reveal medial collateral ligament (MCL) bursitis, meniscal cyst, degeneration changes to the MCL and meniscal protrusion etc. Prolotherapy is effective in these patients. The author performed prolotherapy for MCL bursitis of the knee joint, and confirmed the disappearance of the bursitis using high resolution ultrasound.

• Journal of Oral Medicine and Pain
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• v.39 no.4
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• pp.140-145
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• 2014

Purpose: Temporomandibular disorder (TMD) is one of the most common diseases causing chronic orofacial pain. Prolotherapy is called 'regenerative injection therapy' or 'growth factor stimulation injection', and it induces the functional reactivation of tissues such as ligaments and tendons. The aim of this study is to evaluate the efficacy of ultrasound-guided prolotherapy with platelet-rich plasma (PRP) for the patients who had the TMD symptoms, especially in temporomandibular joint (TMJ) pain, restricted mouth opening, and TMJ sound. Methods: Twenty-seven patients visited Chosun University Dental Hospital with the symptoms of pain, restricted mouth opening, and TMJ sound were included in this study. When the patients visited the hospital, we measured; the degree of pain, range of mouth opening (ROM), and TMJ sound, and grouped them according to their chief complaints. TMJ pain and ROM were measured both at the first visit and the fourth week after the PRP injection, and also evaluated the impact of the treatment on their daily activities. Results: After the treatment, the patients in the TMJ pain group showed some improvement (visual analogue scale [VAS] 5.6 to 3.6), and the patients in the restricted mouth opening group exhibited increased ROM (26 mm to 32 mm; p<0.05). On the other hand, the patients in the TMJ sound group had no improvement. Conclusions: PRP prolotherapy could be effective for the treatment of TMJ pain and restricted mouth opening. However, further studies are still necessary in terms of TMJ sound and longterm effect of PRP prolotherapy.

• The Korean Journal of Pain
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• v.20 no.2
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• pp.130-137
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• 2007

Background: We evaluated the role and effects of prolotherapy in patients presenting with lower back pain and detected sacral asymlocation, by retrospectively analyzing the results of prolotherapy performed at our institute. Methods: Twenty-three patients with referred pain in the lower back rather than distinct radiculopathy, were detected to have sacral asymlocation by simple X-ray from May 2004 through July 2005. The patients were treated with prolotherapy and manipulation by the Ongley's method around the lumbosacral junction, iliolumbar ligament, and sacroiliac joint. They were treated for approximately one to two week intervals, and during this period were rechecked by X-ray and evaluated using the visual analogue scale (VAS). Results: A total of 23 patients were included in the study (10 male and 13 female), and the average age was 41 years. The average VAS at the time of visit was B.5, the average treatment time was 4,7 days, and the average VAS after treatment was 2.1. Conclusions: Back pain, and associated leg and buttock pain, originate from several causes. In these case analyses, instability around the lumbosacral area and sacral asymlocation might have been important causes of patient back pain and associated buttock and leg pain. We therefore applied prolotherapy as well as manipulation techniques devised by Ongley to these patients, and obtained good results.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.3 no.1
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• pp.21-25
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• 2010

Purpose: To evaluate efficacy of ultrasound guided prolotherapy in patients with persistant symptoms after rotator cuff repair. Materials and Methods: Between January and December of 2008, 90 patients who had persistant pain and shoulder adhesion 4 weeks after rotator cuff repair were treated with ultrasound guided prolotherapy. The mean age was 55.2 years. Visual analogue scale (VAS) and range of motion (ROM) before and after the procedure, complications related to the procedure were analyzed. Results: The average VAS score at 4 weeks follow up decreased to $2.5{\pm}2.304$ from $6.3{\pm}1.25$ before prolotherapy and forward flexion range at 4 weeks follow up increased to $143{\pm}26.63$ from $106{\pm}21.64.$ Four weeks after the ultrasound guided prolotherapy, 74 cases(82%) reported of improved pain and ROM, 13 cases(14%) reported of improvement after 2~5 days of the procedure and 3 cases(4%) had no improved in pain and ROM. No complications were encountered. Conclusion: The authors believe that ultrasound guided prolotherapy in repaired rotator cuff tear patients theoretically increased possibilities of healing and with relieving the pain of the patients results in increased possibility of rehabilitation effect.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.4 no.2
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• pp.101-110
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• 2011

To describe the background, mechanism, clinical results and complications of prolotheapy based on the literature review. Prolotherapy is a minimally invasive injection-based treatment of chronic musculoskeletal pain, including ligament and joint laxity. The mechanism of this injection-based technique is to initiate a local inflammatory response with resultant tissue healing. The used proliferants are classified by bio-mechanism to act in three different ways as osmotic, irritants, and chemotatics. The most commonly used proliferant is hyperosmolar (10~25%) dextrose to act by osmotic rupture of cells. High resolution ultrasound imaging of musculoskeletal structure provide a more accurate diagnosis. Also ultrasound-guided intervention provides a more high efficacy and low rate of complications. The most common complication is local pain at the injected site, that is self-limited and good responsive to anti-inflammatory agents. Other complications are rare. It is reported that prolotherapy appears safe when performed by an experienced clinician. Prolotherapy has grown in popularity and has received significant recent attention. However there are limited evidence-based data supporting the indication and efficacy of prolotherapy in the treatment of chronic musculoskeletal pain or soft tissue injuries. Future studies are necessary to determine whether prolotherapy can play an independent and definitive role in a treatment for chronic musculoskeletal pain.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.1 no.2
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• pp.117-121
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• 2008

Prolotherapy can be defined as the injection of growth factors or growth factor production stimulants to grow normal cells or tissue. Even though it has been a controversal procedure for decades, it is currently gaining in popularity among many physicians. The term prolotherapy was coined by Hacket in the 1950s to imply proliferation of normal tissue at ligamentous and tendinous entheses. The procedure has been described by other terms, such as sclerotherapy, regenerative injection therapy, and stimulated ligament repair. Incomplete healing from sprains or strains is common and can lead to chronic pain, joint instability and laxity, and is a risk factor for the development of osteoarthritis. Prolotherapy is commonly used for these musculoskeletal conditions which are refractory to usual care therapies. The proliferant solution and technique varies according to physicial training and preferance. Commonly reported proliferants include 10% to 25% dextrose, P2G and sodium morrhuate. High resolution ultrasound imaging of musculoskeletal tissue is increasing in popularity because of patient tolerability, low cost, ability to visualize tissue in real time motion and superior resolution of highly organized tissue such as a tendon. This procedure can be introduced by ultrasound imaging and tissue growth and repair after this procedure in a tendon or a ligament can be documented with ultrasound.