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Pain and Functional Outcome Comparison of Prolotherapy and Platelet-Rich Plasma Injection Effects on the Sacroiliac Joint: A Descriptive Review

Keshav Godha (Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, Florida); Joshua Rothenberg, DO; Prathap Jayaram, MD; David M. Civitarese, BA

Meeting: AAPM&R Annual Assembly 2020

Categories: Musculoskeletal and Sports Medicine (2020)

Session Information

Session Title: Virtual Poster Hall

Session Time: None. Available on demand.

Disclosures: Keshav Godha: No financial relationships or conflicts of interest

Objective: The purpose of this project is to review the current status of literature regarding the efficacy of regenerative strategies in the treatment of sacroiliac (SI) joint dysfunction.

Design: Systematic review. A review of the literature regarding the existing evidence of prolotherapy and/or platelet-rich plasma interventions on the sacroiliac joint or ligaments was performed using Pubmed, SCOPUS, EMBASE, COCHRANE, and CINAHL. These findings were cataloged through the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Setting : Clinical. Participants : Individuals with disorders of the sacroiliac joint or ligaments treated with interventions through prolotherapy or platelet-rich plasma.

Interventions: Biologics (platelet-rich plasma and prolotherapy).

Main Outcome Measures: Visual analog scale (VAS), numerical rating scale (NRS), Oswestry disability index (ODI), modified Oswestry disability questionnaire (MODQ).

Results: Fifteen studies (six prolotherapy and nine PRP) evaluated the effects of regenerative treatments on the intraarticular SI joint or periligamentous SI structures. Five of the six controlled studies trended positively favoring their respective regenerative treatments when compared to the control group. However, low numbers of patients were included in these studies and statistical significance was only noted at particular time intervals by two of these studies. A single Level I study was reviewed and considered to be the highest quality as a prospective, randomized, controlled trial with a consistent intervention achieving statistically significant outcomes favoring prolotherapy. Conclusions: This review revealed the need for adequately powered well-designed, standardized, double-blinded randomized clinical trials in order to determine the effectiveness of PRP and prolotherapy in SIJ-mediated pain. The existing literature on this topic suggests there may be favorable pain and functional primary outcomes with limited adverse events. However, standardization of these outcome measures in future studies with appropriately designed studies would offer more consistent and comparable data to evaluate treatment effectiveness.

Level of Evidence: Level III

To cite this abstract in AMA style:

Godha K, Rothenberg J, Jayaram P, Civitarese DM. Pain and Functional Outcome Comparison of Prolotherapy and Platelet-Rich Plasma Injection Effects on the Sacroiliac Joint: A Descriptive Review [abstract]. PM R. 2020; 12(S1)(suppl 1). https://pmrjabstracts.org/abstract/pain-and-functional-outcome-comparison-of-prolotherapy-and-platelet-rich-plasma-injection-effects-on-the-sacroiliac-joint-a-descriptive-review/. Accessed May 8, 2025.
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