{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T11:15:17Z","timestamp":1783509317426,"version":"3.55.0"},"reference-count":38,"publisher":"MDPI AG","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Prolotherapy (proliferative therapy) is a nonsurgical regenerative injection technique that introduces small amounts of hyperosmolar dextrose to the site of painful or degenerated tendons or their insertions. Under ultrasound guidance, a 25-gauge needle is used to fenestrate and inject hyperosmolar dextrose into the injured area of the Achilles tendon. This is found to induce the proliferation of new cells, allowing the regeneration of healthy tissue. The purpose of this study was to evaluate the treatment response to prolotherapy in Achilles tendinitis.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods:<\/jats:bold>\n                    We reviewed 132 participants with nontraumatic Achilles tendinopathy. Data were collected retrospectively from electronic health records from January 1, 2014, to December 31, 2017. These participants have Achilles tendinopathy from daily activity. We excluded any traumatic cause, history of Achilles tendon rupture, and tendon pathology. Participants were followed for 12 months; those lost to follow-up were excluded. The duration of pathology, number of prolotherapy sessions, and outcome data were recorded. Musculoskeletal radiologists performed the prolotherapy. We received an exemption from the institutional review board of Boston Medical Center for this study.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    One hundred thirty-two participants (45 men and 87 women) met the study's criteria, with a mean age of 55 years (range, 21\u201380 years). Overall, within 12 months, 98 participants (74.2%) experienced symptom resolution. Seventy-one participants (53.8%) experienced symptom improvement with a single treatment. Thirty-four participants (25.8%) still had symptoms after 12 months.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    This study demonstrated that prolotherapy yielded excellent results for Achilles tendinitis, particularly for participants without skeletal deformities. No adverse events were reported during the 12-month study. A prospective, comparative, and randomized controlled study with long-term follow-up is needed to determine the efficacy of prolotherapy.\n                  <\/jats:p>","DOI":"10.7547\/23-186","type":"journal-article","created":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T14:39:45Z","timestamp":1765895985000},"source":"Crossref","is-referenced-by-count":1,"title":["Prolotherapy for Achilles Tendinopathy"],"prefix":"10.3390","volume":"115","author":[{"given":"Hau","family":"Pham","sequence":"first","affiliation":[{"name":"Department of Surgery, Boston Medical Center, Boston, MA. Dr. Wong is now part of a practice group in Oceanside, CA. Dr. Hutchins is now at Whittier Street Health Center, Boston, MA, and Providence Community Health Centers, Providence, RI. Dr. Amin is now in private practice in Jacksonville, FL. Dr. Reubens is now part of a practice group in Harrisburg, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Tseng","sequence":"additional","affiliation":[{"name":"Department of Surgery, Boston Medical Center, Boston, MA. Dr. Wong is now part of a practice group in Oceanside, CA. Dr. Hutchins is now at Whittier Street Health Center, Boston, MA, and Providence Community Health Centers, Providence, RI. Dr. Amin is now in private practice in Jacksonville, FL. Dr. Reubens is now part of a practice group in Harrisburg, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ewald R.","family":"Mendeszoon","sequence":"additional","affiliation":[{"name":"Department of Surgery, Boston Medical Center, Boston, MA. Dr. Wong is now part of a practice group in Oceanside, CA. Dr. Hutchins is now at Whittier Street Health Center, Boston, MA, and Providence Community Health Centers, Providence, RI. Dr. Amin is now in private practice in Jacksonville, FL. Dr. Reubens is now part of a practice group in Harrisburg, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Surgery, Boston Medical Center, Boston, MA. Dr. Wong is now part of a practice group in Oceanside, CA. Dr. Hutchins is now at Whittier Street Health Center, Boston, MA, and Providence Community Health Centers, Providence, RI. Dr. Amin is now in private practice in Jacksonville, FL. Dr. Reubens is now part of a practice group in Harrisburg, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Hutchins","sequence":"additional","affiliation":[{"name":"Department of Surgery, Boston Medical Center, Boston, MA. Dr. Wong is now part of a practice group in Oceanside, CA. Dr. Hutchins is now at Whittier Street Health Center, Boston, MA, and Providence Community Health Centers, Providence, RI. Dr. Amin is now in private practice in Jacksonville, FL. Dr. Reubens is now part of a practice group in Harrisburg, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anish","family":"Amin","sequence":"additional","affiliation":[{"name":"Department of Surgery, Boston Medical Center, Boston, MA. Dr. Wong is now part of a practice group in Oceanside, CA. Dr. Hutchins is now at Whittier Street Health Center, Boston, MA, and Providence Community Health Centers, Providence, RI. Dr. Amin is now in private practice in Jacksonville, FL. Dr. Reubens is now part of a practice group in Harrisburg, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel B.","family":"Reubens","sequence":"additional","affiliation":[{"name":"Department of Surgery, Boston Medical Center, Boston, MA. Dr. Wong is now part of a practice group in Oceanside, CA. Dr. Hutchins is now at Whittier Street Health Center, Boston, MA, and Providence Community Health Centers, Providence, RI. Dr. Amin is now in private practice in Jacksonville, FL. Dr. Reubens is now part of a practice group in Harrisburg, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","reference":[{"key":"B1","series-title":"The Achilles Tendon: Treatment and Rehabilitation","first-page":"3","article-title":"Anatomy of the Achilles Tendon","author":"Nickisch F","year":"2009","unstructured":"Nickisch F: \u201cAnatomy of the Achilles Tendon,\u201d in The Achilles Tendon: Treatment and Rehabilitation, ed by JA Nunley, p 3, Springer Science + Business Media, Berlin, 2009."},{"key":"B2","series-title":"StatPearls [Internet]","article-title":"Anatomy, Bony Pelvis and Lower Limb: Achilles Tendon","author":"Wong M","year":"2022","unstructured":"Wong M, Jardaly AH, Kiel J: \u201cAnatomy, Bony Pelvis and Lower Limb: Achilles Tendon,\u201d in StatPearls [Internet], StatPearls Publishing, Treasure Island, FL, 2022."},{"key":"B3","series-title":"Scand J Med Sci Sports","first-page":"669","article-title":"Epidemiology of ankle and foot overuse injuries in sports: a systematic review","volume":"23","author":"Sobhani S","year":"2013","unstructured":"Sobhani S, Dekker R, Postema K, et al: Epidemiology of ankle and foot overuse injuries in sports: a systematic review. 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J Bone Joint Surg Am 103: 1295, 2021."},{"key":"B25","series-title":"Arthroscopy","first-page":"1966","article-title":"Meta-analysis comparing autologous blood-derived products (including platelet-rich plasma) injection versus placebo in participants with Achilles tendinopathy","volume":"34","author":"Lin MT","year":"2018","unstructured":"Lin MT, Chiang CF, Wu CH, et al: Meta-analysis comparing autologous blood-derived products (including platelet-rich plasma) injection versus placebo in participants with Achilles tendinopathy. Arthroscopy 34: 1966, 2018."},{"key":"B26","series-title":"Scand J Med Sci Sports","first-page":"4","article-title":"The effect of sclerotherapy and prolotherapy on chronic painful Achilles tendinopathy: a systematic review including meta-analysis","volume":"28","author":"Morath O","year":"2018","unstructured":"Morath O, Kubosch EJ, Taeymans J, et al: The effect of sclerotherapy and prolotherapy on chronic painful Achilles tendinopathy: a systematic review including meta-analysis. Scand J Med Sci Sports 28: 4, 2018."},{"key":"B27","series-title":"Ligament and Tendon Relaxation (Skeletal Disability) Treated by Prolotherapy (Fibro-osseous Proliferation)","author":"Hackett GS","year":"1958","unstructured":"Hackett GS: Ligament and Tendon Relaxation (Skeletal Disability) Treated by Prolotherapy (Fibro-osseous Proliferation), Charles C Thomas, Springfield, IL, 1958."},{"key":"B28","series-title":"Clin Med Insights Arthritis Musculoskelet Disord","first-page":"139","article-title":"A systematic review of dextrose prolotherapy for chronic musculoskeletal pain","volume":"9","author":"Hauser RA","year":"2016","unstructured":"Hauser RA, Lackner JB, Steilen-Matias D, et al: A systematic review of dextrose prolotherapy for chronic musculoskeletal pain. 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Br J Sports Med 45: 421, 2011."},{"key":"B37","series-title":"of mechanisms, techniques, and protocols, and evidence for common musculoskeletal conditions. Phys Med Rehabil Clin N Am","first-page":"165","article-title":"Prolotherapy: a narrative review","volume":"34","author":"Hsu C","year":"2023","unstructured":"Hsu C, Vu K, Borg-Stein J: Prolotherapy: a narrative review of mechanisms, techniques, and protocols, and evidence for common musculoskeletal conditions. Phys Med Rehabil Clin N Am 34: 165, 2023."},{"key":"B38","series-title":"Technique Region Anesth Pain Manag","first-page":"74","article-title":"Regenerative medicine in the field of pain medicine: prolotherapy, platelet-rich plasma therapy, and stem cell therapy\u2014theory and evidence","volume":"15","author":"DeChellis DM","year":"2011","unstructured":"DeChellis DM, Cortazzo MH: Regenerative medicine in the field of pain medicine: prolotherapy, platelet-rich plasma therapy, and stem cell therapy\u2014theory and evidence. 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