Response to Letter to the Editor: Low-Dose Dextrose Prolotherapy as Effective as High-Dose Dextrose Prolotherapy in the Treatment of Lateral Epicondylitis? A Double-Blind, Ultrasound Guided, Randomized Controlled Study

Abstract

In lateral epicondylitis, angiofibroblastic hyperplasia and poor scar tissue occur in response to recurring microtrauma in the tendon, and consequently, complete healing does not take place. In vitro studies using 50% dextrose as a proliferant have shown that exposure of tenocytes to dextrose elicited an inflammatory response through the upregulation of proinflammatory markers, including interleukin 8, cyclooxygenase 2, and prostaglandin 2, and downregulation of anti-inflammatory marker growth factor b.