Early inflammatory response of knee ligaments to prolotherapy in a rat model

Kristina T. Jensen, David P. Rabago, Thomas Best, Jeffrey J. Patterson, Ray Vanderby

Research output: Contribution to journalArticle

53 Citations (Scopus)

Abstract

Prolotherapy is an alternative injection-based therapy for chronic musculoskeletal pain. Three different proliferants, D-glucose (dextrose), phenol-glucose-glycerine (P2G), and sodium morrhuate, used in prolotherapy are hypothesized to strengthen and reorganize chronically injured soft tissue and decrease pain through modulation of the inflammatory process. Our hypothesis is that commonly used prolotherapy solutions will induce inflammation (leukocyte and macrophage infiltration) in medial collateral ligaments (MCLs) compared to needlestick, saline injection, and no-injection controls. MCLs of 84 Sprague- Dawley rats were injected one time at both the tibial and femoral insertions. Immunohistochemistry (IHC) was used to determine the inflammatory response at three locations (tibial and femoral insertions and midsubstance) 6, 24, and 72 h after dextrose injection compared to saline- and no-injection controls and collagenase (positive control) (n = 4). qPCR was used to analyze gene expression 24 h postinjection (n = 4). Sodium morrhuate, P2G, and needlestick control were also investigated after 24 h (n = 4). In general, inflammation (CD43+, ED1+, and ED2+ cells) increased after prolotherapy injection compared to no-injection control but did not increase consistently compared to saline and needlestick control injections. This response varied by both location and proliferant. Inflammation was observed at 6 and 24 h postinjection but was resolved by 72 h compared to no-injection controls (p < 0.05). CD43+ leukocytes and ED2+ macrophages increased compared to needlestick and saline-injection control, respectively, 24 h postinjection (p < 0.05). Prolotherapy injections created an inflammatory response, but this response was variable and overall, not uniformly different from that caused by saline injections or needlestick procedures.

Original languageEnglish (US)
Pages (from-to)816-823
Number of pages8
JournalJournal of Orthopaedic Research
Volume26
Issue number6
DOIs
StatePublished - Jun 1 2008
Externally publishedYes

Fingerprint

Ligaments
Knee
Injections
Needlestick Injuries
Sodium Morrhuate
Glucose
Collateral Ligaments
Thigh
Inflammation
Leukocytes
Macrophages
Nociceptive Pain
Musculoskeletal Pain
Collagenases
Phenol
Chronic Pain
Glycerol
Sprague Dawley Rats
Immunohistochemistry
Gene Expression

Keywords

  • Dextrose
  • Needlestick
  • P2G
  • Saline
  • Sodium morrhuate

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

Early inflammatory response of knee ligaments to prolotherapy in a rat model. / Jensen, Kristina T.; Rabago, David P.; Best, Thomas; Patterson, Jeffrey J.; Vanderby, Ray.

In: Journal of Orthopaedic Research, Vol. 26, No. 6, 01.06.2008, p. 816-823.

Research output: Contribution to journalArticle

Jensen, Kristina T. ; Rabago, David P. ; Best, Thomas ; Patterson, Jeffrey J. ; Vanderby, Ray. / Early inflammatory response of knee ligaments to prolotherapy in a rat model. In: Journal of Orthopaedic Research. 2008 ; Vol. 26, No. 6. pp. 816-823.
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