Impact of Dextrose Injection Therapy for Chronic Anterior Talofibular Ligament Sprain: A Randomized Controlled Trial.

OBJECTIVE

To evaluate the efficacy of ultrasound-guided dextrose injection (DI) therapy for chronic anterior talofibular ligament sprain.

DESIGN

A randomized, single-blinded controlled trial.

SETTING

Participants were recruited from the outpatient department of a medical center.

PARTICIPANTS

Twenty-seven participants (N=27) with chronic anterior talofibular ligament sprain without ligament rupture.

INTERVENTIONS: Ultrasound-guided injection of 15% dextrose (DI group) or normal saline (saline injection group), combined with a home-based physiotherapy program.

MAIN OUTCOME MEASURES: Visual analog scale (VAS) for pain, pressure pain threshold, Foot and Ankle Disability Index, proprioception, ligament thickness, and range of motion.

RESULTS

There was no statistically significant difference in VAS scores between the groups during the 12-week follow-up. Pressure pain threshold improved significantly in the DI group compared to the saline injection group at 12 weeks (6.8±3.0 vs 4.7±1.9, P=.01). Both groups experienced improvements in VAS and Foot and Ankle Disability Index, but no significant differences in range of motion, ligament thickness, or maximum tolerable pressure were observed between groups.

CONCLUSIONS

For chronic ankle sprains, home-based physiotherapy combined with ultrasound-guided injection therapy can help relieve pain and improve ankle function. Compared to saline injection, dextrose injection does not provide a significant benefit in VAS of pain and ankle function and range of motion. However, there is an improvement in pressure pain threshold over long-term follow-up.