Sony Sony, Kantha Manasa, Shekhar Shivam, Kumar Ajit, Bhandari Baibhav, Muthuramalingam Karthik Pandian
Department of Anesthesiology, Pain and Critical Care, AIIMS Deoghar, Jharkhand, India.
Department of Anesthesiology, Pain and Critical Care, AIIMS Rishikesh, Uttarakhand, India.
Indian J Anaesth. 2025 Sep;69(9):881-898. doi: 10.4103/ija.ija_566_25. Epub 2025 Aug 12.
Rotator cuff (RC) disorders have a varied range of treatment. Multiple interventional, non-surgical treatments are often opted for by patients. This study evaluates the effectiveness of dextrose prolotherapy in treating RC pathologies.
A comprehensive review of databases (PubMed, Google Scholar, Embase, Scopus, and Cochrane databases) from 2000 to June 2025 identified 13 relevant studies involving 936 patients. The randomised clinical trials, which compared dextrose prolotherapy with interventions such as platelet-rich plasma, steroids, physiotherapy, or placebos, were included in the systematic review. A risk-of-bias analysis was conducted using the Risk of Bias Visualisation Tool. It indicated that seven studies had low bias. Studies with a high risk of bias were excluded from the meta-analysis. The protocol was registered beforehand (PROSPERO ID: CRD42024520747).
Review Manager software was used to analyse the data and generate the plots. The analysis showed that prolotherapy significantly reduced pain (MD = -0.76; 95% CI: -1.26, -0.27; = 0.003), improved functional outcomes (shoulder pain and disability index (MD = -8.58; 95% confidence interval (CI): -13.00, -4.17; = 0.0001)), and enhanced ultrasonography features. No major adverse effects were reported, indicating that the treatment is safe.
This systematic review and meta-analysis suggests that dextrose prolotherapy may be a feasible and effective alternative for RC disorders, and it can be considered for patients with limited treatment options. However, to reach the required information size, further trials are required. Uniformity in protocols, intervention strategies, and outcome reporting is necessary for longer follow-up periods to facilitate more effective evidence synthesis. This study received no external funding.
肩袖（RC）疾病有多种治疗方法。患者通常会选择多种介入性非手术治疗。本研究评估葡萄糖注射疗法治疗RC病变的有效性。
对2000年至2025年6月的数据库（PubMed、谷歌学术、Embase、Scopus和Cochrane数据库）进行全面检索，确定了13项涉及936例患者的相关研究。将比较葡萄糖注射疗法与富血小板血浆、类固醇、物理治疗或安慰剂等干预措施的随机临床试验纳入系统评价。使用偏倚风险可视化工具进行偏倚风险分析。结果显示7项研究偏倚较低。偏倚风险高的研究被排除在荟萃分析之外。该方案已预先注册（PROSPERO编号：CRD42024520747）。
使用Review Manager软件分析数据并生成图表。分析表明，注射疗法显著减轻了疼痛（MD = -0.76；95%可信区间：-1.26，-0.27；P = 0.003），改善了功能结局（肩痛和功能障碍指数（MD = -8.58；95%置信区间（CI）：-13.00，-4.17；P = 0.0001）），并增强了超声特征。未报告重大不良反应，表明该治疗方法安全。
本系统评价和荟萃分析表明，葡萄糖注射疗法可能是治疗RC疾病的一种可行且有效的替代方法，对于治疗选择有限的患者可以考虑使用。然而，为了达到所需的信息量，还需要进一步的试验。在较长的随访期内，方案、干预策略和结局报告的一致性对于促进更有效的证据综合是必要的。本研究未接受外部资助。
