213 - Dextrose Prolotherapy for the Treatment of Instability and Pain in Ehlers-Danlos Syndrome: A Case Series

Case Diagnosis: Four patients with diagnosis of hypermobile Ehlers-Danlos Syndrome (hEDS)

Case Description: Four patients were followed while undergoing prolotherapy treatment in an outpatient clinic setting. These patients presented with ligamentous laxity and subsequent pain refractory to standard management with medications and therapies. These patients had a diverse range of joints that were targeted, including the knee, shoulder, ankle, and sacroiliac joint. They were evaluated to be good candidates for a trial of dextrose prolotherapy (DPT). Patients were treated with DPT into the joints and associated ligamentous complexes. A description of DPT protocols, as well as special considerations for the hEDS population, will be discussed. All patients had improvement in pain and subjective function. Clinical laxity and functional outcomes were also assessed at 6 week follow-up using the Casa Colina EDS Disability Index.

Discussions: Hypermobile EDS is a common cause of chronic musculoskeletal pain. Current guidelines for treatment include oral analgesics, physical therapy, bracing, orthotic devices, and lifestyle changes. DPT is a regenerative medicine modality with relatively low cost and a favorable safety profile that is becoming more commonly utilized to treat other chronic musculoskeletal conditions, especially in sports medicine. The efficacy of DPT in the treatment of chronic joint pain in patients with hEDS has not been well investigated in literature, nor have descriptions of DPT protocols specifically for hEDS been well documented. We present preliminary data showing positive clinical outcomes in this cohort of patients.

Conclusions: Regenerative medicine modalities such as DPT are a promising adjunctive treatment for the management of chronic joint pain due to instability in patients with hEDS. Here we present a case series of patients with hEDS who experienced improvements in pain and reported functional outcomes after DPT. More research is required to further evaluate the efficacy and establish definitive protocols for DPT in hEDS patients.