Thumb Arthritis

Treatment of Basal Thumb Osteoarthritis: A Retrospective Study of Dextrose Prolotherapy Injections as an Alternative Treatment

Ross Hauser, MD, Feister W. Treatment of basal thumb osteoarthritis: a retrospective study of dextrose prolotherapy injections as an alternative treatment. Journal of Prolotherapy. 2013;5:e913-e921.


Abstract

A common malady of the thumb in the carpometacarpal (CMC) joint is osteoarthritis (OA), also known as basal thumb arthritis or trapeziometacarpal (TMC) arthritis. This affliction is often the result of ligament laxity or injury to the thumb, which then creates a cascade of arthritic effects. This study documents the benefits of Prolotherapy for 13 patients with TMC joint osteoarthritis in 17 of their thumbs. Specifically, Hackett-Hemwall dextrose Prolotherapy counteracts the tissue degeneration that leads to pain and stiffness by creating a healing cascade, which begins with inflammation and proceeds to connective tissue repair. During each treatment session, patients received an average of 10 injections of dextrose—a simple sugar used as a safe inflammatory agent—in the afflicted thumb joint and surrounding connective tissue. In addition, hGH was added to the intra-articular injections for its hormonal effects on cartilage growth. Using the VAS scale, patients were asked to rate pain and stiffness; they also reported on use of medication. Then, questionnaire responses gathered before Prolotherapy were compared with telephone responses after Prolotherapy sessions. Dextrose injections gave 71% of the patients in the study group 50% or more improvement in their daily overall pain level. The follow-up questionnaire shows that of the 17 thumbs, 15 thumbs had achieved the improvements expected by the patients over the course of an average of 4.5 sessions. Among an array of medical treatments, Prolotherapy is one of the most desirable for physicians and patients to consider because the injections enable the body to regenerate injured tissue and rejuvenate function. This study justifies the use of Prolotherapy to remedy the biomechanical failure of basal thumb arthritis.

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