The Effect of Dextrose Injection Therapy on Chronic Anterior Talofibular Ligament Sprain: A Randomized Controlled Trial.

Abstract

To evaluate the efficacy of ultrasound-guided dextrose injection therapy for chronic anterior talofibular ligament (ATFL) sprain. A randomized, single-blinded controlled trial. Physical Medicine and Rehabilitation Department at Taipei Municipal WanFang Hospital. Twenty-seven participants with chronic ATFL sprain without ligament rupture. Ultrasound-guided injection of 15% dextrose (DI group) or normal saline (SI group), combined with a home-based physiotherapy program. Visual Analogue Scale (VAS) for pain, pressure pain threshold (PPT), Foot and Ankle Disability Index (FADI), proprioception, ligament thickness, and range of motion (ROM). There was no statistically significant difference in VAS scores between the groups during the 12-week follow-up. PPT improved significantly in the DI group compared to the SI group at 12 weeks (6.8 ± 3.0 vs. 4.7 ± 1.9, p = 0.01). Both groups experienced improvements in VAS, and FADI, but no significant differences in ROM, ligament thickness or maximum tolerable pressure were observed between groups. For chronic ankle sprains, home-based physiotherapy combined with ultrasound-guided injection therapy can help relieve pain and improve ankle function. By comparing to saline injection, dextrose injection is no significant benefit in VAS of pain and ankle function and ROM. However, there is an improvement in PPT over long-term follow-up.