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Exploring dextrose prolotherapy in rotator cuff disorders: A systematic review and meta-analysis
Sony Sony1, Manasa Kantha2, Shivam Shekhar1
1Department of Anesthesiology, Pain and Critical Care, AIIMS Deoghar, Jharkhand, India.
Indian Journal of Anaesthesia
|August 29, 2025
Summary
Dextrose prolotherapy offers a safe and effective treatment for rotator cuff disorders, significantly reducing pain and improving function. Further research is needed to confirm these promising findings for patients with limited options.
Area of Science:
- Orthopedics
- Regenerative Medicine
- Musculoskeletal Disorders
Background:
- Rotator cuff (RC) disorders encompass a range of pathologies with diverse treatment options.
- Non-surgical interventions are frequently pursued by patients experiencing RC issues.
Purpose of the Study:
- To evaluate the efficacy of dextrose prolotherapy as a treatment for rotator cuff pathologies through a systematic review and meta-analysis.
Main Methods:
- A comprehensive literature search was conducted across major databases (PubMed, Google Scholar, Embase, Scopus, Cochrane) from 2000 to June 2025.
- Included were randomized clinical trials comparing dextrose prolotherapy to other interventions (PRP, steroids, physiotherapy, placebo).
- A risk-of-bias analysis was performed, with high-bias studies excluded from the meta-analysis. Protocol registered (PROSPERO ID: CRD42024520747).
Main Results:
- Dextrose prolotherapy demonstrated a significant reduction in pain (MD = -0.76; P = 0.003) and improved functional outcomes (Shoulder Pain and Disability Index: MD = -8.58; P = 0.0001).
- Ultrasonography features also showed enhancement following treatment.
- No major adverse events were reported, indicating a favorable safety profile.
Conclusions:
- Dextrose prolotherapy presents a viable and effective alternative for managing rotator cuff disorders, particularly for patients with limited treatment alternatives.
- Further high-quality trials with standardized protocols and longer follow-up are necessary to strengthen the evidence base.
- Ensuring uniformity in intervention strategies and outcome reporting will facilitate more robust evidence synthesis.
