Q. On July 26, 2002 my left knee was injured in a motor scooter accident. I sought medical assistance immediately, and was referred to physical therapy. After 5 months of therapy I am still unable to resume my regular activities. I was extremely active and running 7 miles 3x a week before the injury. I am currently unable to run.

The doctor said I was a perfect candidate for prolotherapy, and encouraged me to have the first series of injections, including a growth hormone injected into the area. I felt uncomfortable with this decision and opted to do more research on the subject before attempting prolotherapy. Does prolotherapy work? Should I attempt prolotherapy before surgery? Is it permanent or temporary relief? Would you recommend it on a healthy 45-year-old man, with no other medical problems?

A. First of all, you have had a significant trauma to the knee, meaning even under the best of conditions, all will take time to heal. First you need an accurate diagnosis under the care of an orthopedist which you have done. Cartilage damage in particular has poor healing capabilities. Even the MRI test has limitations when you compare it to what is seen at surgery, so you may need arthroscopy to clarify the extent of damage and to repair what can be fixed. Then careful rehab through physical therapy will give you the best chance for recovery.

Prolotherapy is a technique by which glucose and other substance are injected into joints to "promote healing and relieve pain". This technique has very little scientific evidence to support its claims as to effectiveness and safety. There are numerous websites on prolotherapy, nearly all managed by people who are promoting and performing the technique. My recommendation is to work with an orthopedic specialist who you trust.

http://www.quackwatch.org/01QuackeryRelatedTopics/prolo.html

http://www.physsportsmed.com/issues/2000/08_00/news.htm

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