Efficacy of hypertonic dextrose proliferation therapy in the treatment of rotator cuff lesions: a meta-analysis

Zhang et al. Journal of Orthopaedic Surgery and Research https://doi.org/10.1186/s13018-024-04754-4 (2024) 19:297 RESEARCH ARTICLE Journal of Orthopaedic Surgery and Research Open Access Efficacy of hypertonic dextrose proliferation therapy in the treatment of rotator cuff lesions: a meta-analysis Ting Zhang1†, YanFu Wang1†, Lin Ding1* and ChaoYang Ma1* Abstract Background One of the most prevalent illnesses of the shoulder is rotator cuff tendinosis, which is also a major contributor to shoulder discomfort and shoulder joint dysfunction. According to statistics, rotator cuff tendinosis occurs in 0.3–5.5% of cases and affects 0.5–7.4% of people annually. It will be necessary to conduct a meta-analysis to evaluate the efficacy of hypertonic glucose proliferation therapy in the treatment of rotator cuff problems. Methods The databases Cochrane PubMed, Library, Web of Science and EMbase, are retrieved by the computer. Individuals with rotator cuff lesions in the intervention group were treated with hypertonic dextrose proliferation therapy, whereas individuals in the control condition were treated with a placebo. Outcome markers for rotator cuff lesions patients; Pursuant to studies, the visual analogue scale (VAS) score, the shoulder pain & disability index (SPADI), & other metrics are used to evaluate the effects of hypertonic dextrose proliferation treatment on individuals with rotator cuff diseases. After carefully evaluating the calibre of the literature, data analysis was performed utilising the RevMan 5.3 programme. Results Meta-analysis finally contained 6 papers. In six investigations, the test & control group’s VAS scores improved, with the test team’s score considerably outperforming the control team [standardized mean difference (SMD): 1.10; 95% Cl: 0.37,1.83; P < 0.01], shoulder pain and disability index (SPADI) score (SMD:8.13; 95% Cl: 5.34,10.91; P < 0.01), Flexion (SMD:5.73; 95% Cl: 0.99,10.47; P < 0.05), Abduction (SMD:6.49; 95% Cl: 0.66,12.31; P < 0.05), Internal rotation (SMD:-1.74; 95% Cl: -4.25,0.78; P = 0.176) and External rotation (SMD:2.78; 95% Cl: -0.13,5.69; P = 0.062). Conclusion The findings of this study suggest that individuals with rotator cuff injuries may benefit from hypertonic dextrose proliferation treatment based on the visual analogue scale (VAS) score, the Shoulder Pain and Disability Index (SPADI) score, Flexion, & Abduction. These results must, nevertheless, be supported by high-caliber follow-up research. Keywords Hypertonic dextrose, Prolotherapy, Rotator cuff lesions, Tendon, Meta-analysis † Ting Zhang and YanFu Wang contributed equally to this work. *Correspondence: Lin Ding ChaoYang Ma 1 Department of Rehabilitation Medicine, Central Hospital of Wuhan, Hubei Province, China © The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Zhang et al. Journal of Orthopaedic Surgery and Research (2024) 19:297 Introduction Rotator cuff tendinosis, as one of the most prevalent conditions affecting the shoulder joint, is a significant contributor, etc [1]. . According to reports, the yearly prevalence of rotator cuff tendinosis is 0.5–7.4% and the incidence rate is 0.3–5.5% [2]. In 1972, Neer described rotator cuff tendon disease as three progressive stages: acute tendinitis, tendon degeneration or partial rupture, and complete rupture [3]. Daniel et al. defined rotator cuff tendinosis as a painful disease caused by tendon degeneration or partial tear [4]. Lewis believed that the underlying mechanism is tendon overuse, repair disorders, and ultimately impaired mobility [5]. A variety of conditions may contribute to shoulder cuff tendon disease, including specifically internal, external, & comprehensive factors. The compression of tendons caused by surrounding bone and soft tissue structures is an external factor, while older age, damage to nutrient vessels, and excessive use of tendons are internal factors. These factors can lead to tendon wear and partial or full layer tearing of the shoulder sleeve [6]. Tendons, a kind of connective tissue, are crucial for the movement of the body because they link muscles to bones. Tendon disease can occur in any tendon, but the most common ones are the shoulders, elbows, knees, and Achilles tendons. The occurrence of tendinosis is usually related to overuse or injury of tendons. Common symptoms include pain, swelling, limited mobility, and decreased muscle strength. Tendonopathy can be divided into many types, including tendinitis (inflammation of the tendon), Tendinopathy (degeneration or degeneration of tendon) and tendon rupture. The pathological characteristics of this disease are characterized by chronic changes such as collagen fiber degeneration disorder, cell hypertrophy, and tendon thickening visible under the microscope. The treatment methods for tendinosis include rest, physical therapy, medication, and surgery. Rest can reduce the stress and inflammatory response of tendons. Physical therapy includes massage, physical therapy, and tendon traction, which helps promote blood circulation and tendon repair. The commonly used drugs include nonsteroidal anti-inflammatory drugs, local hormone injections and Analgesics. Severe tendon disease may require surgical repair of the tendon. Prolotherapy originated in the 5th century before christ. Hippocrates proposed to simulate tendon healing through stimulation to achieve the effect of repairing damaged tendons, which is called proliferation and regeneration therapy [7]. It was found that secondary inflammation in the affected area not only did not worsen the condition but also promoted the self-healing effect of locally damaged connective tissue. The term Prolotherapy means offspring, which induce the regeneration of new cells by stimulating or damaging the injured site. Page 2 of 9 At present, prolotherapy has been widely used in clinical practice. Non-operative treatment is selected for patients with traumatic diseases of the (...truncated)