Do Pain and Function Improve after Dextrose Prolotherapy or Autologous Platelet-Rich Plasma Injection in Longstanding Groin Pain?

Abstract

Longstanding groin pain is a non-infectious and inflammatory chronic condition that causes inguinal pain in athletes. We compared dextrose prolotherapy (15% dextrose solution) and platelet-rich plasma (autologous platelet gel, plasma rich in growth factors, platelet concentrate) injections in male soccer players with longstanding groin pain. Forty elite male soccer players, ages between 13 and 33, with longstanding groin pain were treated. Patients were randomly divided into the dextrose prolotherapy (n= 9) and platelet-rich plasma injection (n= 6) groups. Following three injections, all patients were enrolled in the 12-week progressive home exercise protocol. Pain and function were assessed using the visual analogue (VAS) and Nirschl Pain Phase Scale (NPPS) scores before, one month after, and six months after the injection, respectively. VAS and NPPS scores decreased in both of the dextrose prolotherapy and the platelet-rich plasma injection groups. A decrease in pain and improvement in function were evident at a month after injection, and they remained favourable at the end of six months (VAS overall, p <0.001 and p= 0.003, respectively) (NPPS overall, p <0.001 and p= 0.007, respectively). A difference between the dextrose prolotherapy and the platelet-rich plasma injection groups was not observed at both time points (VAS, p= 0.3, p= 0.7, and p= 0.6 respectively) (NPPS, p= 0.6, p= 0.9, and p= 0.9 respectively). Dextrose prolotherapy and platelet-rich plasma injections decreased pain and improved function in longstanding groin pain treatment of male soccer players. These treatments should be considered in patients who are not responding to conservative treatment modalities.

Keywords

• longstanding groin pain
• athletic pubalgia
• injection
• symphysis pubis
• bone marrow oedema