Regenerative Injection of Elite Athletes with Career-Altering Chronic Groin Pain Who Fail Conservative Treatment

Topol, Gastón Andrés; Reeves, Kenneth Dean

doi:10.1097/phm.0b013e31818377b6

Cited by 56 publications

(38 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…20 Another study on sports-altering tendinosis (adductor and abdominal insertions) in elite rugby and soccer athletes resolved career-threatening chronic groin pain in Ͼ90% of athletes. 22 The speed and success rate for return to sport in the adductor/abdominal tendinosis study were the same as that reported with far more expensive surgical interventions. In this OSD study, similar efficacy was demonstrated, but it also represents the first study in an exclusively pediatric population, and the first study in which a tendon attachment on an apophysis was injected.…”

Section: Comparison With Relevant Findings From Other Published Studiessupporting

confidence: 65%

“…Our plan for enrollment was to reach a minimum of 20 cases in each group, on the basis of a previous study using a similar injection treatment. 22 …”

Section: Ethics and Analysismentioning

confidence: 99%

“…5,6 Recent MRI and ultrasound reports are also consistent with a description of OSD as "a tendinopathy/ apophysosis of the patellar tendon/tibial tubercle." [7][8][9][10][11][12] Safety and level A-C evidence of efficacy (per US Preventive Services Task Force criteria) of injection of 10% to 25% dextrose in areas of damaged ligament, tendon, and cartilage in adults has been demonstrated in randomized controlled trials in Achilles tendinosis, 13 finger osteoarthritis, 14 knee osteoarthritis, 15 lateral epicondylosis, 16 sacroiliac joint pain, 17 and in case series collections of patients with Achilles degeneration, 18,19 anterior cruciate ligament laxity, 20 coccygodynia, 21 hip adductor and abdominal tendinosis, 22 and plantar fasciosis. 23 There are no previous reports of application of dextrose injection in a strictly pediatric population, nor are there reports of injection about an apophysis where, as described, the source of pain and pathomechanism are not yet clear.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Hyperosmolar Dextrose Injection for Recalcitrant Osgood-Schlatter Disease

Topol¹,

Podestá

Reeves

et al. 2011

Pediatrics

Self Cite

View full text Add to dashboard Cite

WHAT'S KNOWN ON THIS SUBJECT:Osgood-Schlatter disease symptoms may wax and wane until maturity and affect sport confidence and participation periodically. Chronic sequelae may include anterior knee pain, kneeling discomfort, or sports limitation. Symptom reduction parallels resolution of patellar tendinopathy by MRI/ultrasound, although ossicles may persist radiographically. WHAT THIS STUDY ADDS:Small-needle injection of the patellar tendon enthesis/tibial apophysis with 12.5% dextrose was safe and well tolerated in adolescents with recalcitrant OsgoodSchlatter disease. Dextrose injection resulted in more rapid and frequent achievement of unaltered sport and asymptomatic sport than did usual care. abstract OBJECTIVE: To examine the potential of dextrose injection versus lidocaine injection versus supervised usual care to reduce sport alteration and sport-related symptoms in adolescent athletes with OsgoodSchlatter disease. PATIENTS AND METHODS: Girls aged 9 to 15 and boys aged 10 to 17 were randomly assigned to either therapist-supervised usual care or double-blind injection of 1% lidocaine solution with or without 12.5% dextrose. Injections were administered monthly for 3 months. All subjects were then offered dextrose injections monthly as needed. Unaltered sport (Nirschl Pain Phase Scale Ͻ 4) and asymptomatic sport (Nirschl Pain Phase Scale ϭ 0) were the threshold goals. RESULTS: Sixty-five knees in 54 athletes were treated. Compared with usual care at 3 months, unaltered sport was more common in both dextrose-treated (21 of 21 vs 13 of 22; P ϭ .001) and lidocaine-treated (20 of 22 vs 13 of 22; P ϭ .034) knees, and asymptomatic sport was more frequent in dextrose-treated knees than either lidocaine-treated (14 of 21 vs 5 of 22; P ϭ .006) or usual-care-treated (14 of 21 vs 3 of 22; P Ͻ .001) knees. At 1 year, asymptomatic sport was more common in dextrose-treated knees than knees treated with only lidocaine (32 of 38 vs 6 of 13; P ϭ .024) or only usual care (32 of 38 vs 2 of 14; P Ͻ .0001). CONCLUSIONS: Our results suggest superior symptom-reduction efficacy of injection therapy over usual care in the treatment of OsgoodSchlatter disease in adolescents. A significant component of the effect seems to be associated with the dextrose component of a dextrose/ lidocaine solution. Dextrose injection over the apophysis and patellar tendon origin was safe and well tolerated and resulted in more rapid and frequent achievement of unaltered sport and asymptomatic sport than usual care. Pediatrics 2011;128:e1121-e1128

show abstract

Section: Comparison With Relevant Findings From Other Published Studiessupporting

confidence: 65%

“…Our plan for enrollment was to reach a minimum of 20 cases in each group, on the basis of a previous study using a similar injection treatment. 22 …”

Section: Ethics and Analysismentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Hyperosmolar Dextrose Injection for Recalcitrant Osgood-Schlatter Disease

Topol¹,

Podestá

Reeves

et al. 2011

Pediatrics

Self Cite

View full text Add to dashboard Cite

show abstract

“…There is substantial evidence from non-randomized prospective and retrospective studies as well as case reports that cannot be discussed here due to a limited size of this publication [17][18][19][20][21][22]65 ] . Similar results were demonstrated by Alfredson et al in peripheral tendinosis [52][53][54][55] and Topol et al in groin strains [79][80][81][82][83] .…”

Section: Clinical Effectivenesssupporting

confidence: 89%

“…The challenge will continue to determining which speci fi c growth factors should be used. The other viable possibility is injection of engineered, typespeci fi c tissue derived from stem-cell research [ 83,84,154 ] . Some variations of nanotechnology will be also added.…”

Section: Discussionmentioning

confidence: 99%