SEARCHRCTrheumatology, internal medicine

RCT·rheumatology, internal medicine, clinical trial, preclinical research·PMC10378817

The level of ratio between matrix metalloproteinase-1 (MMP-1) and tissue inhibitor matrix metalloproteinase-1 (TIMP-1) after prolotherapy intervention and the functional outcome in patient with frozen shoulder: A randomized controlled trial

Medicine · 10 authors, 8 centres

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TL;DR

This randomized controlled trial compared dextrose prolotherapy to normal saline injections in patients with frozen shoulder. Prolotherapy significantly increased the MMP-1/TIMP-1 ratio, a biomarker associated with fibrosis repair, at 6 and 12 weeks post-intervention.

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This single-blinded RCT evaluated prolotherapy versus normal saline for frozen shoulder, measuring the MMP-1/TIMP-1 biomarker ratio and functional outcomes. Prolotherapy significantly increased the MMP-1/TIMP-1 ratio from baseline to weeks 6 and 12 (P=.036 within-group), with a significant between-group difference at these timepoints (P=.002). The study suggests prolotherapy may influence a biomarker of fibrosis repair and improve some functional outcomes in frozen shoulder.

STUDY TYPE

RCT

SPECIALTY

rheumatology

SUMMARISED BY

AI pipeline

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100% · A

ORIGINAL PAPER

PMC10378817

The level of ratio between matrix metalloproteinase-1 (MMP-1) and tissue inhibitor matrix metalloproteinase-1 (TIMP-1) after prolotherapy intervention and the functional outcome in patient with frozen shoulder: A randomized controlled trial

Medicine

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ABSTRACT

Objective: To determine the effect of prolotherapy on functional outcome changes, along with ratio of matrix metalloproteinase-1 (MMP-1)/tissue inhibitor matrix metalloproteinase-1 (TIMP-1) as an indicator of tissue repair in the glenohumeral joint in frozen shoulder patients. Design: Single-blinded randomized controlled trial. Subjects/Patients: Participants with frozen shoulder. Methods: The prolotherapy group is the study group, and the normal saline (NS) group is the control group. Each group was given injections at weeks 0, 2, 4, and 6. Level of biomarker levels was measured at week 6 and week 12 after there. Functional outcomes were measured at weeks 0, 6, and 12. Results: A significant difference in week 6 and week 12 was demonstrated in the ratio of MMP-1/TIMP-1 level between the prolotherapy group and the normal saline group ( P value = .002). Both groups performed well regarding the Numerical Rating Scale score and functional outcome. Compared to the normal saline group, prolotherapy changed the mean range of motion in flexion and internal rotation. Conclusion: Prolotherapy is considered to play a role in repairing cartilage based on biomarker assessment, particularly the ratio of MMP-1/TIMP-1—prolotherapy effectiveness in improving functional outcome and Numerical Rating Scale score.

CITATION EXPORT

Nuralam Sam, Irawan Yusuf, Irfan Idris et al.. The level of ratio between matrix metalloproteinase-1 (MMP-1) and tissue inhibitor matrix metalloproteinase-1 (TIMP-1) after prolotherapy intervention and the functional outcome in patient with frozen shoulder: A randomized controlled trial. Medicine. (2023). https://doi.org/10.1097/MD.0000000000034356

AUTHORS

10 · 8 CENTRES

Nuralam Sam, Irawan Yusuf, Irfan Idris, Endy Adnan, Ratna Darjanti Haryadi, Firdaus Hamid, Andry Usman, Muhammad Phetrus Johan, Andi Alfian Zainuddin, Agussalim Bukhari

a Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
b Department of Physiology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
c Rheumatology Divison, Department of Internal Medicine, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
d Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Airlangga University, Surabaya, Indonesia
e Doctor from Department of Microbiology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
f Department of Orthopedic, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
g Department of Public Health, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
h Department of Clinical Nutrition, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.