Poster 361: Prolotherapy in the Treatment of Sports-Related Tendinopathies: A Systematic Review

Objectives: Prolotherapy (PrT) involves the injection of a proliferant in order to irritate microenvironment and promote healing via inflammatory cascade. PrT has become an increasingly popular nonoperative treatment orthopedics. However, numerous prolotherapy solutions exist varying applications results have been described. The purpose this study is review high-quality randomized controlled trials (RCTs) that analyzed efficacy safety profiles treatments for most common sports-related tendinopathies. Methods: All RCTs published English between January 1st 1980 July 30th 2021, reported Embase, Medline, Web Science databases, were queried with search terms including sclerotherapy, prolotherapy, sports medicine, injuries, tendinopathies, musculoskeletal pain/injuries. PRISMA guidelines used. Studies analyzing tendinopathies using RCT design included, while case controls, reviews, observational studies excluded. Duplicates eliminated through Endnote. remaining articles screened by titles, followed abstract then full text analysis. Cochrane collaboration tool was used assess risk bias. Two researchers independently performed screening conflicts resolved Rayyan © software (Rayyan Systems Inc., Cambridge, MA, USA). Graphical representations created SPSS version 28.00. Results: Application inclusion exclusion criteria yielded 20 (fig. 1): 6 on lateral epicondylitis (LE); rotator cuff tendinopathy (RC); 5 plantar fasciitis (PF); 2 Osgood-Schlatter disease (OSD); 1 Achilles tendinosis. Most dextrose injections over P2G or hypertonic glucose 2), studied conditions LE RC (fig.3). average follow-up period 12 weeks. No significant adverse effects reported, outcome measures visual analog scale (VAS), patient rated tennis elbow evaluation (PRTEE), quick- disabilities arm, shoulder, hand (Q-DASH), symptoms relief. For LE, associated improvement VAS pain score at rest PRTEE compared normal saline (p<0.041, p<0.013 respectively). Additionally, hyaluronic acid lifestyle modifications, showed activity, Q-DASH, scores (p<0.04, p<0.04, p<0.05 RC, found superior physiotherapy shoulder disability index (p<0.001). Finally, demonstrated improvements foot function (p<0.001) PF, reduction OSD (p<0.024) physical therapy lidocaine controls. Patients AT had more rapid combined PrT/eccentric loading exercises protocols alone (p<0.007). A graphical representation figure 4. Conclusions: This systematic summarized high quality be overall safe effective Further larger sample sizes comparisons orthobiologics would add literature. Based current findings, medicine professionals may safely pursue as additional component conservative before surgery.