Is Dextrose Prolotherapy Superior To Corticosteroid Injection In Patients With Chronic Lateral Epicondylitis?: A Randomized Clinical Trial
Received 7 June 2019
Accepted for publication 8 October 2019
Published 5 November 2019 Volume 2019:11 Pages 167—175
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Nicola Ludin
Peer reviewer comments 3
Editor who approved publication: Professor Clark Hung
Masume Bayat,1 Seyed Ahmad Raeissadat,2 Maryam Mortazavian Babaki,3 Shahram Rahimi-Dehgolan4
1Physical Medicine and Rehabilitation Department of Mahdiyeh Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 2Clinical Development Research Center of Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 3Physical Medicine and Rehabilitation Department & Research Center, Shohada-E-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 4Physical Medicine and Rehabilitation Department of Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
Correspondence: Maryam Mortazavian Babaki
No. 1989934148, Shohada-e-Tajrish Hospital, Tehran, Iran
Purpose: To compare the efficacy of dextrose prolotherapy versus steroid injection in the treatment of patients with chronic lateral epicondylitis.
Methods: Thirty subjects with chronic lateral epicondylitis were randomly assigned into two groups of hypertonic dextrose or methylprednisolone injection. Participants were assessed through Quick DASH and VAS scores, once before injection, and then after 1- and 3-months follow-up. Two patients were excluded due to not completing the follow-up timepoints.
Results: In both groups VAS scores revealed significant improvement during the first month follow-up [mean difference (MD) = 1.9±3.3, versus 1.5±1.9 for the prolotherapy and steroid groups, respectively]. This declining trajectory continued at the third month visit in the prolotherapy group and MD reached 4.4±2.9, while it did not change remarkably in the steroid group (MD=1.9±3.4). In fact, comparing VAS scores between the 1st- and 3rd-month time points did not reveal a significant improvement in the steroid group (p=0.6). Also, the Quick DASH index showed a similar pattern and improved remarkably in both groups during the first visit. However, only the efficacy in the prolotherapy group persisted after 3-month follow-up (MD = 9.5±21.6, p=0.044). One month after injections no preference between the two interventions was observed (p=0.74 for VAS and 0.14 for Quick DASH score). However, the 3rd-month follow-up revealed a meaningful superiority (p=0.03 for VAS and p=0.01 for Quick DASH score) favoring the prolotherapy method.
Conclusion: Both methods were proven to be effective in the short-term treatment of chronic lateral epicondylitis, but dextrose prolotherapy seems to be slightly more efficacious than steroid injection over a longer period.
Clinical trial registration: Iranian Registry of Clinical Trials Database: IRCT20170311033000N3.
Keywords: regenerative medicine, tennis elbow, methylprednisolone, prolotherapy
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