In 2020 Ozkan et al published a treatment comparison study of dextrose prolotherapy versus platelet rich plasma injection for treatment of chronic groin pain. The citation of this study is Ozkan, O., Torgutalp, S. S., Karacoban, L., Donmez, G., & Korkusuz, F. (2020). Do pain and function improve after dextrose prolotherapy or autologous platelet-rich plasma injection in longstanding groin pain?. Montenegrin Journal of Sports Science and Medicine, 9(2), 5-12. The link to the article PDF is here --> http://www.mjssm.me/clanci/MJSSM_September_2020_Ozkan.pdf Note that it is not secure but is from the journal itself (Montenegro Journal of Sports Science in Medicine) For your convenience here click on the link below to open.
Here is a summary of that article
•Design: This was a retrospective cohort study. Three weekly injection sessions were given with either 8 ml of 15% dextrose via single skin penetration and 3-4 redirections to nearby tender areas, versus 5 ml of buffy coat PRP in a similar method.
•Candidates: Elite male soccer players who had anterior and medial groin pain at least 6 months, resistant to conservative treatment methods. They had a painful pubic symphysis and pubic ramus, and pain with resisted adduction.
•Study size: 15 participants ( 9 DPT and 6 PRP ).
• Allocation/Randomization Bias: Random assignment is mentioned and yet group size was unequal. This was not explained. Allocation and blinding methods were not clearly described although block randomization was mentioned. This would be considered to introduce at least moderate risk of bias.
•Measures: VAS and Nirschl Pain Phase Scale (NPPS) to 6 months post injection. VAS was a standard scale. Othere scales perferred for function but the NPPS was used before in a moderately large consecutive patient trial and has the advantage of 0 meaning no pain AND no stiffness either before or after sport.
•ITT (intention to treat) versus Per Protocol aanalysis: Intention to treat analysis was used and data was obtained on all participants to 6 months.
•Other treatments given: No exercises during the 3 week injection period. After 3 injections all were enrolled in a 12 week progressive home exercise protocol
•Results: A marked improvement resulted in VAS pain (87.5% in both groups), and in NPPS (80% in DPT and 89% in PRP) with no between-group differences.
•Limitations: Retrospective design is a limitation along with a lack of description about how randomization was applied. This would be a B- level of evidence for dextrose due to a comparative treatment desing and the blinding bias.
•Strength: Using the same tools as the larger (n=72) Topol et al study consecutive patient study in 2008, (Topol GA, Reeves KD. Regenerative injection of elite athletes with career-altering chronic groin pain who fail conservative treatment: a consecutive case series. Am J Phys Med Rehabil. 2008;87(11):890-902), the outcomes were virtually identical for pain improvement (87% Ozcan versus 82% Topol) and NPPS improvement (80% Ozcan versus 78% Topol)
•Design: This was a retrospective cohort study. Three weekly injection sessions were given with either 8 ml of 15% dextrose via single skin penetration and 3-4 redirections to nearby tender areas, versus 5 ml of buffy coat PRP in a similar method.
•Candidates: Elite male soccer players who had anterior and medial groin pain at least 6 months, resistant to conservative treatment methods. They had a painful pubic symphysis and pubic ramus, and pain with resisted adduction.
•Study size: 15 participants ( 9 DPT and 6 PRP ).
• Allocation/Randomization Bias: Random assignment is mentioned and yet group size was unequal. This was not explained. Allocation and blinding methods were not clearly described although block randomization was mentioned. This would be considered to introduce at least moderate risk of bias.
•Measures: VAS and Nirschl Pain Phase Scale (NPPS) to 6 months post injection. VAS was a standard scale. Othere scales perferred for function but the NPPS was used before in a moderately large consecutive patient trial and has the advantage of 0 meaning no pain AND no stiffness either before or after sport.
•ITT (intention to treat) versus Per Protocol aanalysis: Intention to treat analysis was used and data was obtained on all participants to 6 months.
•Other treatments given: No exercises during the 3 week injection period. After 3 injections all were enrolled in a 12 week progressive home exercise protocol
•Results: A marked improvement resulted in VAS pain (87.5% in both groups), and in NPPS (80% in DPT and 89% in PRP) with no between-group differences.
•Limitations: Retrospective design is a limitation along with a lack of description about how randomization was applied. This would be a B- level of evidence for dextrose due to a comparative treatment desing and the blinding bias.
•Strength: Using the same tools as the larger (n=72) Topol et al study consecutive patient study in 2008, (Topol GA, Reeves KD. Regenerative injection of elite athletes with career-altering chronic groin pain who fail conservative treatment: a consecutive case series. Am J Phys Med Rehabil. 2008;87(11):890-902), the outcomes were virtually identical for pain improvement (87% Ozcan versus 82% Topol) and NPPS improvement (80% Ozcan versus 78% Topol)