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Prolotherapy Help

Discussion in 'General Issues and Discussion Forum' started by SarahR, May 13, 2013.

  1. SarahR

    SarahR Active Member

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    I am interested in initiating a discussion regarding prolotherapy for cartilage damage.

    If you employ this modality, please share your case experience. Are there any other options apart from joint replacement you are using successfully in cases of cartilage damage? I am particularly interested in the ankle joint, mortise and talar dome injury.

    This is partly selfish, I have recently sustained a bimalleolar fracture and cartilage damage is pretty much a guarantee. I may need this long term, so want some info on the benefits, risks, outcomes, how to administer, who is providing if I need it myself and have to come to one of your offices for an injection or two. If this is a beneficial procedure in your collective experience, it may be a good thing to add to my management options, so workshop or a mentorship would be in order.

    I have a patient who experienced a severe ankle sprain and may benefit from this therapy herself and I would like to send her to someone for a consult.

    Colleagues in and around Minneapolis Minnesota. Is there anyone experienced in administering Prolotherapy? She is only 6 hours away and willing to travel to a US based Podiatrist or Orthopedist who has experience in prolotherapy. This service is not very accessible here let alone in the Ontario Hinterlands.

    She fell bouldering (rock climbing low routes without a rope) and caught the foot on the edge of the bouldering mattress causing severe injury.

    The stability and muscle strength are reported to be decent post rehabilitation, however there has been cartilage damage and she is interested in pursuing prolotherapy to try and stimulate some healing and improve joint stability. I have not personally looked at her for some time as she has moved to Thunder Bay Ontario, 18 hours away from my office. I recommended orthotics to address biomechanical strain, however she moved prior to us being able to get her into a pair. She has been advised to pursue this option to help reduce abnormal joint motion and address abnormal mechanics but I suspect this will not be adequate to achieve desired results.

    Please include how much are you charging for consult and administration, and how many are typically required.

    30 y/o female, previously very active with cycling, running, walking, rock climbing, ultimate frisbee, unable to participate in frisbee, running, limited walking and climbing are now possible, cycling is okay.
    Hx of MVA, no podiatrically significant residual concerns if memory serves
    Fibromyalgia, Raynauds

    CC Hyper inversion injury (it was more than that though a nice twisted mess) with cartilage damage.
    MRI results
    Lateral aspect there is evidence of sprain along anterior tibiofibular ligament, interosseous talocalcaneal ligaments and the dorsal talonavicular ligaments, milder in posterior tibiofibular ligament adjacent to fibula. No evidence of ligamentus disruption. Peroneal tendosynovitis, tendons intact.
    Medial aspect there is evidence of sprain in deltoid ligament, worst is posterior tibiotalar component. No evidence of ligamentus disruption. Tendons intact, increased fluid in flexor hallucis longus.
    Within ankle, small focus of grade IV chondromalacia with subchondral marrow edema involving lateral margin of the talar dome measuring 6 x 10 mm along the articular surface. There is also similar focal grade IV chondromalacia involving the anterior articular surface of the medial malleolus measuring approximately 12 x 6.5 mm along the articular surface. The subtalar joint appears intact. No significant marrow signal abnormality in the calcaneous.
    Retrocalc bursitis.
    This scan was May 2012.

    She is still in pain and has only been able to get back to approximately 30% of her previous activity level.

    Thank You!

  2. AngieR

    AngieR Active Member

    Shame it's Peterborough, Canada and not England otherwise I would have done it for you :)
    Prolotherapy is excellent for all cartilage issues. Ross Hauser is from Caring Medical Illinois is the man I would contact as he is a pro. He may know who usin your area.

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