Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, WI, 53715, USA.
Curr Rheumatol Rep. 2017 Jun;19(6):34. doi: 10.1007/s11926-017-0659-3.
Osteoarthritis and overuse tendinopathy are common chronic conditions of high societal and patient burden. The precise etiology of pain and disability in both conditions is multifactorial and not well understood. Patients are often refractory to conservative therapy. The development of new therapeutic options in both conditions is a public health priority. Prolotherapy is an injection-based outpatient regenerative therapy for chronic musculoskeletal conditions, including osteoarthritis and tendinopathy. The authors reviewed the basic science and clinical literature associated with prolotherapy for these conditions.
Systematic review, including meta-analysis, and randomized controlled trials suggest that prolotherapy may be associated with symptom improvement in mild to moderate symptomatic knee osteoarthritis and overuse tendinopathy. Although the mechanism of action is not well understood and is likely multifactorial, a growing body of literature suggests that prolotherapy for knee osteoarthritis may be appropriate for the treatment of symptoms associated with knee osteoarthritis in carefully selected patients who are refractory to conservative therapy and deserves further basic and clinical science investigation for the treatment of osteoarthritis and tendinopathy.
骨关节炎和过度使用性腱病是具有高社会和患者负担的常见慢性疾病。这两种疾病疼痛和残疾的确切病因是多因素的,目前尚未完全了解。患者通常对保守治疗无反应。因此,这两种疾病中新的治疗选择的发展是公共卫生的重点。增生疗法是一种基于注射的慢性肌肉骨骼疾病的门诊再生疗法,包括骨关节炎和腱病。作者回顾了与增生疗法治疗这些疾病相关的基础科学和临床文献。
系统评价,包括荟萃分析和随机对照试验表明,增生疗法可能与轻度至中度症状性膝骨关节炎和过度使用性腱病的症状改善相关。尽管其作用机制尚不清楚且可能是多因素的,但越来越多的文献表明,对于对保守治疗无反应且精心选择的患者,增生疗法治疗膝骨关节炎可能适用于与膝骨关节炎相关的症状,值得进一步进行基础和临床科学研究,以治疗骨关节炎和腱病。