Method: One millimeter of three proliferant solutions (20% dextrose water-group A, 5% dextrose water mixed with NaCl-group B, NaCl solution-group C) with the same osmolarity (1,110 mOsm) was injected around the right Achilles tendon of each rat, whereas the left was not injected to be used as control. After six weeks of injection, the injected tendons and controls were obtained. The transverse diameter of gross specimen, the count of fibroblasts on light microscope, and the findings of cross- sectional analysis using electron microscope were compared.

Results: Overall, transverse diameter and the count of fibroblasts increased in the injected specimens compared to controls, however, their significant differences were demonstrated only for the two groups injected with dextrose containing solutions (p＜0.05). However, A and B groups did not show significant differences in all parameters investigated. On electron micrograph, fibril diameters of solution- injected tendon consisted of either extremely large or small sizes with the limited intermediate sizes.

Conclusion: Although high osmolar solution could increase the transverse diameter and fibroblast counts, however, dextrose-containing solution was much more effective as a proliferant solution. (J Korean Acad Rehab Med 2003; 27: 935-940)

Objective: To evaluate the effects of dextrose prolotherapy on knee osteoarthritis.

Method: The patient population consisted of 20 individuals with knee osteoarthritis. Patients have suffered from knee pain for six months or more along with Kellgren's grade 2 or more radiographical change in knee compartment. They were injected monthly with 15% and 25% dextrose on knee joints for 4 months. The outcome was measured by visual analogue scale (VAS) for pain, pain rating score, and WOMAC osteoarthritis index at a month after 4th injection.

Results: Seventeen of the 20 patients achieved significant diminution of pain or disability scores after dextrose prolotherapy compared with pre-treatment status. There were significant reductions in VAS score, pain rating score, and WOMAC osteoarthritis index after dextrose injection (p＜0.05). Three patients dropped out over follow up period due to lack of efficacy.

Conclusion: Prolotherapy injection with dextrose resulted in clinically and statistically significant improvements in knee osteoarthritis. (J Korean Acad Rehab Med 2002; 26: 445-448)

Objective: The purpose of this study was to evaluate the effects of the prolotherapy on the healing of the tendon tissue and the proliferation of fibroblasts in the injured Achilles tendons.

Method: The tendons of twenty eight Sprague-Dawley rats were transected at 2 mm above the calcaneal insertion in the right Achilles tendon and sutured. Then they were allocated randomly into two groups: prolotherapy group and control group. We injected 20% dextrose 0.1 ml on injured tendon area of prolotherapy group immediately after transection. After 2 and 4 weeks, the diameters of tendons were measured on both the injured and uninjured tendon. The number of fibroblasts and the ratio of fibroblast to fibrocyte on the injured tendon tissues were measured by the image analyzer.

Results: The diameters of the injured tendons of the prolotherapy group were not significantly different with that of the control group. However, the number of fibroblasts and the ratio of fibroblast to fibrocyte in the prolotherapy group showed significantly larger and more increased than the control group (p＜0.05).

Conclusion: This result showed the additional regeneration effect of the prolotherapy on the healing of the injured tendon tissue. Therefore, the prolotherapy would be an effective treatment on the tendon injury. (J Korean Acad Rehab Med 2002; 26: 332-336)

Objective: The goal of this study was to determine the efficacy of prolotherapy in relieving the pain of patients with tendon or ligament laxity.

Method: The subjects were 67 patients (40 male, 27 female) who were suffering from chronic musculoskeletal pain, excluding those with metabolic diseases that could influence the nature of the pain. The effect of the treatment was evaluated by checking the VAS score after a monthly injection of 15% dextrose solution injected around the patient's ligaments and teno-osseous junction that were suspicious of laxity. This same procedure was followed after a second injection. To make an accurate evaluation before and after the treatment, the use of NSAID, physical therapy or exercise therapy was prohibited.

Results: The mean pain duration of the subjects was 5.48⁑7.04 years, and the mean age of the subjects was 49.58⁑16.52 years. The result from VAS showed a statistically remarkable reduction after the injection (p＜0.01). The VAS decreased from 7.00⁑0.17 to 4.31⁑0.21 after the first injection and this score further decreased to 2.55⁑0.19 after the second injection. There was no statistically significant relationship between the duration of pain and the effect of the treatment (p＞0.05).

Conclusion: This research demonstrated that prolotherapy is an effective method in treating patients with chronic musculoskeletal pain caused by tendon or ligament relaxation.