Dextrose Prolotherapy for Supraspinatus Partial Tear: A Case Report

Abstract

Introduction: Rotator cuff (RC) tears account for about 20% of RC disorders and presents with severe shoulder pain that can significantly impact activities of daily life. Case report: A 34-year-old male with a history of chronic right shoulder pain presents with tenderness at the lateral shoulder, positive subacromial impingement tests, painful end range of motion and pain score of 6. Ultrasound shows a partial supraspinatus tear at the bursal side. The patient was treated with 15% dextrose to the supraspinatus tendon intrasubstance 3 times, for 4 weeks. Result: Significant pain improvement after the first treatment (VAS 1), with pain-free full range of motion until 4 weeks after treatment and sonographic evidence of supraspinatus tendon healing. Discussion: Dextrose concentrations higher than 12.5% produce an osmotic gradient which stimulates the accumulation of growth factors and inflammatory cells, which in turn can initiate the wound healing process. In this case we can find that the healing process translates to good clinical outcome by ultrasound imaging. Conclusion: Dextrose prolotherapy can be used as an option for supraspinatus tendon partial tear with good results.