Evaluation of the effectiveness of dextrose prolotherapy in rotator cuff disease: A prospective randomized controlled study

Objective: The aim of the study is to investigate the effectiveness of dextrose prolotherapy applied using ultrasound-guided marking method in chronic rotator cuff disease. Methods: In this prospective, randomized and controlled study, 60 patients between the ages of 30-65 with shoulder pain for more than 3 months were included. Patients were randomized into two groups. The prolotherapy group (PG, n = 30) was injected with prolotherapy, while the saline group (SFG, n = 30) received saline injections. Home exercise program and patient training were given to both groups. The patients were evaluated with shoulder joint range of motion, visual analog scale (VAS), Shoulder pain and disability index (SPADI), UCLA Shoulder Assessment Score, Ultrasound Shoulder Pathology Rating Scale (USPRS) scores before treatment, 1 month and 3 months after the last injection. In statistical analysis, significance level was accepted as p <0.05 in all evaluations. Results: The mean age of 58 patients who completed the study was 53.9 ± 6.4 years. At baseline, there was no significant difference between the two groups in respect to demographic and clinical characteristics of the participants (p>0.05). In both groups, significant improvement was found in the evaluation criteria at 1 month and 3 months after treatment compared to baseline. Compared to the saline group in the prolotherapy group, there was a significant decrease in pain with VAS (p<0,001), significant improvement in OADI and UCLA shoulder assessment scales (p<0,001), significant increase in active shoulder flexion, abduction, internal rotation and external rotation range of motion (p<0,001) were detected at 1st and 3rd months after treatment. The change in the USPRS score was found to be significant in the prolotherapy group compared to the saline group at the 3rd month after treatment (p<0.001). Conclusion: In this study, it was determined that dextrose prolotherapy applied together with home exercise program in chronic rotator cuff disease reduced shoulder pain and increased shoulder function and range of motion. In addition, dextrose prolotherapy has been shown to have a positive effect on structural changes that may support regeneration. Keywords: Rotator cuff, shoulder pain, prolotherapy