Response of knee ligaments to prolotherapy in a rat injury model

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

Research output: Contribution to journalArticle

49 Citations (Scopus)

Abstract

Background: Prolotherapy is an alternative therapy for chronic musculoskeletal injury including joint laxity. The commonly used injectant, D-glucose (dextrose), is hypothesized to improve ligament mechanics and decrease pain through an inflammatory mechanism. No study has investigated the mechanical effects of prolotherapy on stretch-injured ligaments. Hypotheses: Dextrose injections will enlarge cross-sectional area, decrease laxity, strengthen, and stiffen stretch-injured medial collateral ligaments (MCLs) compared with controls. Dextrose prolotherapy will increase collagen fibril diameter and density of stretch-injured MCLs. Study Design: Controlled laboratory study. Methods: Twenty-four rats were bilaterally MCL stretch-injured, and the induced laxity was measured. After 2 weeks, 32 MCLs were injected twice, 1 week apart, with either dextrose or saline control; 16 MCLs received no injection. Seven uninjured rats (14 MCLs) were additional controls. Two weeks after the second injection, ligament laxity, mechanical properties (n = 8), and collagen fibril diameter and density (n = 3) were assessed. Results: The injury model created consistent ligament laxity (P <.05) that was not altered by dextrose injections. Cross-sectional area of dextrose-injected MCLs was increased 30% and 90% compared with saline and uninjured controls, respectively (P <.05). Collagen fibril diameter and density were decreased in injured ligaments compared with uninjured controls (P <.05), but collagen fibril characteristics were not different between injured groups. Conclusion: Dextrose injections increased the cross-sectional area of MCLs compared with saline-injected and uninjured controls. Dextrose injections did not alter other measured properties in this model. Clinical Relevance: Our results suggest that clinical improvement from prolotherapy may not result from direct effects on ligament biomechanics.

Original languageEnglish (US)
Pages (from-to)1347-1357
Number of pages11
JournalAmerican Journal of Sports Medicine
Volume36
Issue number7
DOIs
StatePublished - Jul 1 2008
Externally publishedYes

Fingerprint

Collateral Ligaments
Ligaments
Knee
Glucose
Wounds and Injuries
Injections
Collagen
Joint Instability
Complementary Therapies
Mechanics
Biomechanical Phenomena
Pain

Keywords

  • Dextrose
  • Healing
  • Medial collateral ligament
  • Saline
  • Subfailure damage

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

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

In: American Journal of Sports Medicine, Vol. 36, No. 7, 01.07.2008, p. 1347-1357.

Research output: Contribution to journalArticle

Jensen, Kristina T. ; Rabago, David P. ; Best, Thomas ; Patterson, Jeffrey J. ; Vanderby, Ray. / Response of knee ligaments to prolotherapy in a rat injury model. In: American Journal of Sports Medicine. 2008 ; Vol. 36, No. 7. pp. 1347-1357.
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abstract = "Background: Prolotherapy is an alternative therapy for chronic musculoskeletal injury including joint laxity. The commonly used injectant, D-glucose (dextrose), is hypothesized to improve ligament mechanics and decrease pain through an inflammatory mechanism. No study has investigated the mechanical effects of prolotherapy on stretch-injured ligaments. Hypotheses: Dextrose injections will enlarge cross-sectional area, decrease laxity, strengthen, and stiffen stretch-injured medial collateral ligaments (MCLs) compared with controls. Dextrose prolotherapy will increase collagen fibril diameter and density of stretch-injured MCLs. Study Design: Controlled laboratory study. Methods: Twenty-four rats were bilaterally MCL stretch-injured, and the induced laxity was measured. After 2 weeks, 32 MCLs were injected twice, 1 week apart, with either dextrose or saline control; 16 MCLs received no injection. Seven uninjured rats (14 MCLs) were additional controls. Two weeks after the second injection, ligament laxity, mechanical properties (n = 8), and collagen fibril diameter and density (n = 3) were assessed. Results: The injury model created consistent ligament laxity (P <.05) that was not altered by dextrose injections. Cross-sectional area of dextrose-injected MCLs was increased 30{\%} and 90{\%} compared with saline and uninjured controls, respectively (P <.05). Collagen fibril diameter and density were decreased in injured ligaments compared with uninjured controls (P <.05), but collagen fibril characteristics were not different between injured groups. Conclusion: Dextrose injections increased the cross-sectional area of MCLs compared with saline-injected and uninjured controls. Dextrose injections did not alter other measured properties in this model. Clinical Relevance: Our results suggest that clinical improvement from prolotherapy may not result from direct effects on ligament biomechanics.",
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