Document Detail

Hypertonic dextrose and morrhuate sodium injections (prolotherapy) for lateral epicondylosis (tennis elbow): results of a single-blind, pilot-level, randomized controlled trial.
MedLine Citation:
PMID:  23291605     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Chronic lateral epicondylosis is common, debilitating, and often refractory. Prolotherapy (PrT) is an injection therapy for tendinopathy. The efficacy of two PrT solutions for chronic lateral epicondylosis was evaluated.
DESIGN: This study is a three-arm randomized controlled trial. Twenty-six adults (32 elbows) with chronic lateral epicondylosis for 3 mos or longer were randomized to ultrasound-guided PrT with dextrose solution, ultrasound-guided PrT with dextrose-morrhuate sodium solution, or watchful waiting ("wait and see"). The primary outcome was the Patient-Rated Tennis Elbow Evaluation (100 points) at 4, 8, and 16 wks (all groups) and at 32 wks (PrT groups). The secondary outcomes included pain-free grip strength and magnetic resonance imaging severity score.
RESULTS: The participants receiving PrT with dextrose and PrT with dextrose-morrhuate reported improved Patient-Rated Tennis Elbow Evaluation composite and subscale scores at 4, 8, and/or 16 wks compared with those in the wait-and-see group (P < 0.05). At 16 wks, compared with baseline, the PrT with dextrose and PrT with dextrose-morrhuate groups reported improved composite Patient-Rated Tennis Elbow Evaluation scores by a mean (SE) of 18.7 (9.6; 41.1%) and 17.5 (11.6; 53.5%) points, respectively. The grip strength of the participants receiving PrT with dextrose exceeded that of the PrT with dextrose-morrhuate and the wait and see at 8 and 16 wks (P < 0.05). There were no differences in magnetic resonance imaging scores. Satisfaction was high; there were no adverse events.
CONCLUSIONS: PrT resulted in safe, significant improvement of elbow pain and function compared with baseline status and follow-up data and the wait-and-see control group. This pilot study suggests the need for a definitive trial.
David Rabago; Ken S Lee; Michael Ryan; Amrish O Chourasia; Mary E Sesto; Aleksandra Zgierska; Rick Kijowski; Jessica Grettie; John Wilson; Daniel Miller
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  American journal of physical medicine & rehabilitation / Association of Academic Physiatrists     Volume:  92     ISSN:  1537-7385     ISO Abbreviation:  Am J Phys Med Rehabil     Publication Date:  2013 Jul 
Date Detail:
Created Date:  2013-06-20     Completed Date:  2013-08-23     Revised Date:  2014-07-02    
Medline Journal Info:
Nlm Unique ID:  8803677     Medline TA:  Am J Phys Med Rehabil     Country:  United States    
Other Details:
Languages:  eng     Pagination:  587-96     Citation Subset:  AIM; IM    
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MeSH Terms
Chronic Disease
Drug Therapy, Combination
Follow-Up Studies
Glucose Solution, Hypertonic / therapeutic use*
Injections, Intra-Articular
Middle Aged
Pain Measurement
Pilot Projects
Quality of Life*
Range of Motion, Articular / drug effects*,  physiology
Reference Values
Risk Assessment
Severity of Illness Index
Single-Blind Method
Sodium Morrhuate / therapeutic use*
Tennis Elbow / drug therapy*,  ultrasonography
Treatment Outcome
Ultrasonography, Doppler
Grant Support
Reg. No./Substance:
0/Glucose Solution, Hypertonic; 8031-09-2/Sodium Morrhuate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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