Research Studies: ACL Laxity

Anterior Cruciate Ligament (ACL)
Laxity


 

DEX: Reeves et al 2003 Dextrose Tightens Loose ACL Ligament by Simple Injection

Reeves KD Hassanein K Long term effects of dextrose prolotherapy for anterior cruciate ligament laxity: A prospective and consecutive patient study. Alt Ther Hlth Med May-Jun 2003, 9(3): p58-62.

Dr. Reeves' Notes:  The "method" for this study was that 16 knees with machine measured ACL laxity (KT-1000 arthrometer) were injected bimonthly with 10-25% dextrose solution for 1 year and then an average of 4 times yearly thereafter until 3 year follow-up.  Summary: Using simple dextrose injection into 16 knees with a loose ACL ligament, 10/16 knees were no longer loose by machine measurement at time of follow-up, and symptoms were improved. Symptom of osteoarthritis improved even in those who still tested loose. At the 3 year follow-up pain with walking had improved by 43% , subjective swelling improved 63%, flexion range of motion improved by 10.5 degrees, and KT1000 ADD (machine measure of ACL ligament looseness) improved by 71%.

The entire study is available in PDF format here.

The abstract is available here, with a copy of the content below...

OBJECTIVE: Determine the 1 and 3 year efficacy of dextrose injection prolotherapy on anterior cruciate ligament (ACL) laxity. After year 1, determine patient tolerance of a stronger dextrose concentration (25% versus 10%).

DESIGN: Prospective consecutive patient trial.

SETTING: Outpatient physical medicine clinic.

PATIENTS OR OTHER PARTICIPANTS: Eighteen patients with 6 months or more of knee pain plus ACL knee laxity. This laxity was defined by a KT1000 anterior displacement difference (ADD) of 2 mm or more.

INTERVENTION: Intraarticular injection of 6-9 cc of 10% dextrose at months 0, 2, 4, 6, and 10. Injection with 6 cc of 25% dextrose at 12 months. Then, depending on patient preference, injection of either 10% or 25% dextrose every 2-4 months (based on patient preference) through 36 months.

MAIN OUTCOME MEASURES: Visual analogue scale (VAS) for pain at rest, pain on level surfaces, pain on stairs, and swelling. Goniometric flexion range of motion, and KT1000-measured ADD were also measured. All measurements were obtained at 0, 6, 12 and 36 months.

RESULTS: Two patients did not reach 6 month data collection, 1 of whom was diagnosed with disseminated cancer. The second was wheelchair-bound and found long-distance travel to the clinic problematic. Sixteen subjects were available for data analysis. KT1000 ADD, measurement indicated that 6 knees measured as normal (not loose) after 6 months, 9 measured as normal after 1 year (6 injections), and 10 measured as normal at 3 years. At the 3 year follow-up, pain at rest, pain with walking, and pain with stair use had improved by 45%, 43%, and 35% respectively. Individual paired t tests indicated subjective swelling improved 63% (P = .017), flexion range of motion improved by 10.5 degrees (P = .002), and KT1000 ADD improved by 71% (P = .002). Eleven out of 16 patients preferred 10% dextrose injection.

CONCLUSION: In patients with symptomatic anterior cruciate ligament laxity, intermittent dextrose injection resulted in clinically and statistically significant improvement in ACL laxity, pain, swelling, and knee range of motion.

 

K. Dean Reeves, M.D. is a physician and medical researcher in the area of pain caused by arthritis, chronic sprains and chronic strains. His private practice is located in the greater Kansas City area of Roeland Park, Kansas.  He collaborates in research with other locations across the country and internationally, and is licensed in the states of Kansas and Missouri.

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Dr. K. Dean Reeves

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