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. At present, prolotherapy has been widely used in clinical practice. Non-operative treatment is selected for patients with traumatic diseases of the Skeleton, such as temporomandibular joint disorder, Neuropathic pain, pain caused by intervertebral disc herniation, low back pain, lumbar sprain, lumbar muscle strain, pain in sacroiliac joints, and diseases related to bone joints, tendons and ligaments of lower limbs, such as knee Osteoarthritis, secondary ankle sprain, Achilles tendinitis Non-stop Achilles tendinitis, etc., so Prolotherapy is a pain management method. The injected proliferative agents are clinically divided into irritants, chemoattractants and penetrants, among which the more common clinical drugs are phenol solution, Zinc sulfate solution, glycerin, sodium Cod liver oil and hypertonic dextrose solution.
Prolotherapy is a method of injecting proliferating agents into the damaged tendon or ligament to induce new cells to proliferate and repair soft tissue. Hypertonic dextrose is commonly used as the proliferating agent. Hypertonic dextrose can induce hyperosmotic dehydration at the injection site, induce inflammatory reactions, increase glucose utilization, & encourage type III collagen fibres at the damage site to become type I collagen fibres, promoting repair. Hypertonic dextrose Prolotherapy can induce inflammatory reactions in damaged tissues and initiate body repair [
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9].
Unfortunately, although many studies have evaluated the efficacy of hypertonic glucose proliferation therapy in the treatment of rotator cuff problems, there have been no relevant meta-analyses that integrate the latest research.In this study, we conducted a meta-analysis to assess the efficacy of hypertonic dextrose proliferation therapy in the treatment of rotator cuff problems, which will bring light for those who suffered from rotator cuff lesions.