Anserine Bursitis Clinical Trial
Official title:
Efficacy of Neural Prolotherapy Versus Local Corticosteroid Soft Tissue Injection for Treatment of Anserine Bursitis
Anserine bursitis is a common etiology of medial knee pain. It could be severe enough to
limit the patient's functional abilities with affection of the quality of life. The etiology
of AB is unknown. It could be bursitis, tendinitis or other unknown etiology.
The treatment of AB includes conservative and surgical treatment. Conservative treatment
consists of non-pharmacologic treatment and pharmacologic treatment. Local corticosteroid
injection is a treatment for refractory chronic anserine bursitis.
Neural prolotherapy is the subcutaneous perineural injection of isotonic dextrose 5% in water
solution at the fascial penetration point of the sensory nerve where it reaches the
subcutaneous plane and along its course. It can be used for the treatment of chronic anserine
bursitis.
This study aimed to determine the efficacy of neural prolotherapy subcutaneous perineural
injection versus corticosteroid local soft tissue injection therapy for relieving pain and
improvement of function among patients with chronic anserine bursitis.
Anserine bursitis is a common etiology of medial knee pain. It could be severe enough to
limit the patient's functional abilities with affection of the quality of life. The etiology
of AB is unknown. It could be bursitis, tendinitis or other unknown etiology.
The treatment of AB includes conservative and surgical treatment. Conservative treatment
consists of non-pharmacologic treatment and pharmacologic treatment. Their aim is pain
relieve, with subsequent improvement of function and quality of life. The non-pharmacologic
treatment consisted of activity modification with avoidance of precipitating activities and
physiotherapy. The pharmacologic treatment consists of non-steroidal anti-inflammatory drugs,
analgesics whether oral as acetaminophen or topical preparations; or local soft tissue
injection of corticosteroid. Surgical treatment is indicated after failure of conservative
treatment in chronic severe and resistant cases only.
Local corticosteroid injection is a treatment for refractory chronic anserine bursitis. The
mechanism of action of corticosteroid is the suppression of the inflammatory process
associated with anserine bursitis. Subsequently, improvement of anserine bursitis takes
place.
Neural prolotherapy is the subcutaneous perineural injection of isotonic dextrose 5% in water
solution at the fascial penetration point of the sensory nerve where it reaches the
subcutaneous plane and along its course. It can be used for the treatment of chronic anserine
bursitis.
The mechanism of action of neural prolotherapy in anserine bursitis could be due to
stimulation the release of a group of growth factors that enhance soft tissue healing in
response to isotonic dextrose 5% in water solution injection. Subcutaneous injection of
isotonic dextrose 5% in water solution was found to stimulate human cells to start
proliferation, increase in cell protein and DNA synthesis. It stimulates the release of a
group of growth factors as transforming growth factor-β and other growth factors. Another
mechanism of neural prolotherapy is the treatment of neurogenic inflammation.
This study aimed to determine the efficacy of neural prolotherapy subcutaneous perineural
injection versus corticosteroid local soft tissue injection therapy for relieving pain and
improvement of function among patients with chronic anserine bursitis.
;