Reeves K Dean, Hassanein Khatab M
Department of Biometry, University of Kansas Medical Center, Kansas City, Kan., USA.
Altern Ther Health Med. 2003 May-Jun;9(3):58-62.
Use of dextrose prolotherapy. Prolotherapy is defined as injection that causes growth of normal cells or tissue.
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%).
Prospective consecutive patient trial.
Outpatient physical medicine clinic.
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.
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.
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.
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.
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.
葡萄糖注射增殖疗法的应用。增殖疗法定义为可促使正常细胞或组织生长的注射疗法。
确定葡萄糖注射增殖疗法对前交叉韧带（ACL）松弛的1年和3年疗效。在第1年后，确定患者对更高浓度葡萄糖（25%对比10%）的耐受性。
前瞻性连续患者试验。
门诊物理医学诊所。
18例膝关节疼痛6个月及以上且伴有ACL膝关节松弛的患者。这种松弛通过KT1000前向位移差值（ADD）2mm或更大来定义。
在第0、2、4、6和10个月关节内注射6 - 9cc 10%葡萄糖。在第12个月注射6cc 25%葡萄糖。然后，根据患者偏好，在36个月内每2 - 4个月注射10%或25%葡萄糖（根据患者偏好）。
静息痛、平路行走痛、上下楼梯痛和肿胀的视觉模拟量表（VAS）。还测量了关节活动度的测角屈曲范围以及KT1000测量的ADD。所有测量均在第0、6、12和36个月时进行。
2例患者未达到6个月的数据收集，其中1例被诊断为播散性癌症。另1例依赖轮椅，发现长途前往诊所存在困难。16名受试者可用于数据分析。KT1000 ADD测量表明，6个月后6个膝关节测量为正常（不松弛），1年后（6次注射）9个膝关节测量为正常，3年后10个膝关节测量为正常。在3年随访时，静息痛、行走痛和上下楼梯痛分别改善了45%、43%和35%。个体配对t检验表明主观肿胀改善了63%（P = .017），关节活动度屈曲范围改善了10.5度（P = .00），KT1000 ADD改善了71%（P = .002）。16例患者中有11例更喜欢10%葡萄糖注射。
对于有症状的前交叉韧带松弛患者，间歇性葡萄糖注射导致ACL松弛、疼痛、肿胀和膝关节活动度在临床和统计学上有显著改善。
