The effectiveness of PROLOTHERAPY for recalcitrant Medial TIBIAL Stress Syndrome: a prospective consecutive CASE series

Abstract Background Medial tibial stress syndrome (MTSS) is one of the most common lower leg injuries in sporting populations. It accounts for between 6 and 16% all running injuries, up to 53% military recruits. Various treatment modalities are available with varying degrees success. In recalcitrant cases, surgery often only option. Objective To evaluate whether ultrasound-guided injection 15% dextrose MTSS decreases pain facilitates a return desired activity levels those who may otherwise be considering or giving sport. Method The study design was prospective consecutive case series involving eighteen patients: fifteen male three female; (mean age = 31.2 years) MTSS. They were referred from sports injury clinics across UK, having failed conservative treatment. Intervention An sub-periosteal administered by same clinician (NP) along length symptomatic area. Typically, 1 mL solution injected per cm Main outcome measures Pain assessed using 10-cm visual analog scale (VAS) at baseline, short-term, medium-term 18 weeks), long-term 52 weeks) follow-up. Symptom resolution measured Likert medium Statistical analyses performed SPSS Mac version 19.0.0 (IBM, New York, NY, US). Shapiro-Wilk test used normality distribution data. Friedman’s non-parametric compare within-patient response over time. Post-hoc Wilcoxon signed-rank tests Bonferroni corrections determine VAS average five paired periods. Results Patients reported significant ( p < 0.01) reduction median score follow-up compared baseline. Median improvement patient 4.5/10. rated their condition as ‘much improved’ ‘returned but not pre-injury level’ No adverse events reported. Conclusions Ultrasound-guided prolotherapy has effect on This benefit maintained long-term; however, more robust trials required validate these findings absence controls. Clinical relevance Clinicians should consider use viable option reduce aid patients