Prolotherapy, PRP, or knee surgery for high school soccer players

Scott R. Greenberg, MDScott R. Greenberg, MD

Many parents call our office about making an appointment for their player’s knee pain. One of the first things they ask is “Should we I get an MRI?”

Recent research suggest that in a 12 – 15 year old male soccer player, “MRI findings should be interpreted cautiously and in close correlation with clinical findings.” In other words, better have a good physical examination and rely on that.

How come? Researchers writing in the American Journal of Roentgenology (A journal dedicated to Radiology) say that they evaluated the 56 knees of 28 boys 14-15 years old with no known knee problems. Participants were divided into two groups and paired by age and weight: soccer players (28 knees) and control subjects (28 knees). Abnormalities were assessed.”

They found 64% of the soccer players had one or more MRI abnormalities and 32% of the non-soccer playing boys had knee MRI findings!

Before you consider the surgical option based on an MRI

Before you consider the surgical option based on an MRI, before you take your star athlete off the field for a year of surgical recovery, a consultation with a doctor trained in non-surgical treatment of ligament and tendon injuries, such as Prolotherapy and PRP Platelet Rich Plasma Therapy, may be an option to explore.

What we see in the teenage athlete’s knee

After examination we find Osgood-Schlatter Disease to be a common knee problem in the teenage athlete. This can be caused by wear and tear to the patellar tendon (which connects knee cap to shin bone). This is a difficult problem to treat if one relies on anti-inflammatory medications, knee braces and tape. The reason is that this is now seen as a problem of degeneration as opposed to a problem of inflammation – or actually – not enough natural inflammation to heal the tendon.

Recent research suggets dextrose Prolotherapy provided that extra inflammation and offered “superior symptom-reduction efficacy of injection therapy over usual care in the treatment of Osgood-Schlatter disease in adolescents. A significant component of the effect seems to be associated with the dextrose component of a dextrose/lidocaine solution. Dextrose injection over the apophysis and patellar tendon origin was safe and well tolerated and resulted in more rapid and frequent achievement of unaltered sport and asymptomatic sport than usual care.”2

In other words, Dextrose Prolotherapy has the ability to put the athlete back on the field with a stronger knee without surgery or need for prescription medications.

1. Soder RB, Simões JD, Soder JB, Baldisserotto M. MRI of the knee joint in asymptomatic adolescent soccer players: a controlled study. AJR Am J Roentgenol. 2011 Jan;196(1):W61-5.

2. Topol GA, Podesta LA, Reeves KD, et al. Hyperosmolar Dextrose Injection for Recalcitrant Osgood-Schlatter Disease. JWatch Pediatrics. 2011; 2011:1109 2

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