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Lee HJ, Ju J, Choi E, Nahm FS, Choe GY, Lee PB. Effect of epidural polydeoxyribonucleotide in a rat model of lumbar foraminal stenosis. Korean J Pain 2021; 34:394-404. [PMID: 34593657 PMCID: PMC8494961 DOI: 10.3344/kjp.2021.34.4.394] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 06/16/2021] [Accepted: 06/17/2021] [Indexed: 11/05/2022] Open
Abstract
Background We aimed to investigate the effect of epidural polydeoxyribonucleotide (PDRN) on mechanical allodynia and motor dysfunction in a rat model of lumbar foraminal stenosis (LFS). Methods This study was conducted in two stages, using male Sprague-Dawley rats. The rats were randomly divided into eight groups. In the first stage, the groups were as follows vehicle (V), sham (S), and epidural PDRN at 5 (P5), 8 (P8), and 10 (P10) mg/kg; and in the second stage, they were as follows intraperitoneal PDRN 8 mg/kg, epidural 3,7-dimethyl-1-propargilxanthine (DMPX) (0.1 mg/kg), and DMPX (0.1 mg/kg). The LFS model was established, except for the S group. After an epidural injection of the test solutions, von Frey and treadmill tests were conducted for 3 weeks. Subsequently, histopathologic examinations were conducted in the V, S, P5, and P10 groups. Results A total of 65 rats were included. The P8 and P10 groups showed significant recovery from mechanical allodynia and motor dysfunction at all time points after drug administration compared to the V group. These effects were abolished by concomitant administration of DMPX. On histopathological examination, no epineurial inflammation or fibrosis was observed in the epidural PDRN groups. Conclusions Epidural injection of PDRN significantly improves mechanical allodynia and motor dysfunction in a rat model of LFS, which is mediated by the spinal adenosine A2A receptor. The present data support the need for further research to determine the role of epidural PDRN in spinal stenosis treatment.
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Affiliation(s)
- Ho-Jin Lee
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea.,Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jiyoun Ju
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Eunjoo Choi
- Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Korea.,Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Francis Sahngun Nahm
- Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Korea.,Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Ghee Young Choe
- Department of Pathology, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
| | - Pyung Bok Lee
- Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Korea.,Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
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Migliorini F, Maffulli N, Eschweiler J, Bestch M, Tingart M, Baroncini A. Ozone injection therapy for intervertebral disc herniation. Br Med Bull 2020; 136:88-106. [PMID: 33128379 DOI: 10.1093/bmb/ldaa032] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 05/10/2020] [Accepted: 08/23/2020] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Lumbar disc herniation (LDH) is a common cause of low back pain (LBP). Recently, in the setting of LBP caused by LDH, a growing interest in ozone therapies has been observed. SOURCE OF DATA Recent published literatures. AREAS OF AGREEMENT Being low back pain more common in the elderlies, exploring conservative alternatives to the surgical intervention is of especial interest. AREAS OF CONTROVERSY Efficacy and feasibility of ozone injections for LDH is debated. Several clinical studies showed controversial results, and the true benefit has not yet been clarified. GROWING POINTS Systematically summarize current evidences, analyze the quantitative available data and investigate the role of percutaneous ozone therapy for LDH. AREAS TIMELY FOR DEVELOPING RESEARCH Current evidence encourage the use of ozone therapy for LBP from LDH. These conclusions should be interpret in light of the limitations of the present study.
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Affiliation(s)
- Filippo Migliorini
- Department of Orthopaedics, RWTH University Clinic Aachen, Aachen, Germany, Pauwelsstraβe 30, 52074 Aachen
| | - Nicola Maffulli
- Department of Medicine, Surgery and Dentistry, University of Salerno, Via S. Allende, 84081 Baronissi (SA), Italy.,School of Pharmacy and Bioengineering, Keele University School of Medicine, Thornburrow Drive, Stoke on Trent, England.,Queen Mary University of London, Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Mile End Hospital, 275 Bancroft Road, London E1 4DG, England
| | - Jörg Eschweiler
- Department of Orthopaedics, RWTH University Clinic Aachen, Aachen, Germany, Pauwelsstraβe 30, 52074 Aachen
| | - Marcel Bestch
- University of Toronto Orthopaedic Sports Medicine Program (UTOSM), Women's College Hospital, 76 Grenville St, Toronto, ON, Canada
| | - Markus Tingart
- Department of Orthopaedics, RWTH University Clinic Aachen, Aachen, Germany, Pauwelsstraβe 30, 52074 Aachen
| | - Alice Baroncini
- Department of Orthopaedics, RWTH University Clinic Aachen, Aachen, Germany, Pauwelsstraβe 30, 52074 Aachen.,Department of Orthopaedics, El Hadara University Hospital Lambroso, Alexandria, Egypt
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Kim YN, Baek J, Kim YH, Hwang J, Ko YR, Lee MS, Kim YC, Park HJ. Full recovery of near complete tear of anterior cruciate ligament without surgery: a case report. Medicine (Baltimore) 2020; 99:e19899. [PMID: 32358356 PMCID: PMC7440291 DOI: 10.1097/md.0000000000019899] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION The anterior cruciate ligament (ACL) is the region where spraining or tearing is most prevalent when the knee is injured. Complete ACL ruptures have a much less favorable outcome without surgical intervention. Polydeoxyribonucleotide (PDRN) is a relatively safe substance widely used for regenerative therapy. PATIENT CONCERNS A 43-year-old female patient visited our clinic with Rt. knee pain after slipping, which she rated as 7/10 on a numeric rating scale. DIAGNOSIS She was diagnosed as having a near complete tear of the ACL at the femoral attachment, partial tear of the lateral collateral ligament. INTERVENTIONS Ultrasound-guided PDRN injections were carried out 5 times at intervals of about 2 weeks. OUTCOMES At 3-month follow-up, the patient demonstrated an improvement in knee symptoms (numeric rating scale 0) and ROM without any complications. Even after 2 years and 5 months since the diagnosis, she has been doing her daily life well without any pain. CONCLUSION This is the first report of successful PDRN injection for near complete tear of ACL and partial tear of lateral collateral ligament without surgery.
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Affiliation(s)
- Yoo Na Kim
- Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital
| | - Jungwon Baek
- Department of Anesthesiology and Pain Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Young Hoon Kim
- Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital
| | - Jaewoong Hwang
- Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital
| | - Yu Ri Ko
- Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital
| | - Min soo Lee
- Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital
| | - Young chan Kim
- Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital
| | - Hue Jung Park
- Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital
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Effect of Polydeoxyribonucleotide Injection in a Patient With Carpal Tunnel Syndrome. Am J Phys Med Rehabil 2019; 97:e93-e95. [PMID: 29373371 DOI: 10.1097/phm.0000000000000901] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Ultrasound-guided corticosteroid injection into the carpal tunnel is widely performed for the management of carpal tunnel syndrome. However, this injection may worsen the condition in patients with type 2 diabetes mellitus. Polydeoxyribonucleotide was recently recognized as a substitute for corticosteroid because of its anti-inflammatory effects. A 41-yr-old woman with type 2 diabetes mellitus was admitted to our rehabilitation clinic with a 1-mo history of numbness and tingling in her right hand and first three fingers tips. She declined corticosteroid treatment because of a previous episode of uncontrolled blood glucose levels after corticosteroid injection. Therefore, ultrasound-guided polydeoxyribonucleotide injections into the carpal tunnel were carried out. At the 6-mo follow-up, the patient demonstrated an improvement in the carpal tunnel syndrome symptoms without any complications. Thus, polydeoxyribonucleotide injections into the carpal tunnel can be an alternative to corticosteroid injections for carpal tunnel syndrome if there are limitations because of adverse effects of the latter.
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Yoon S, Kang JJ, Kim J, Park S, Kim JM. Efficacy and Safety of Intra-articular Injections of Hyaluronic Acid Combined With Polydeoxyribonucleotide in the Treatment of Knee Osteoarthritis. Ann Rehabil Med 2019; 43:204-214. [PMID: 31072087 PMCID: PMC6509584 DOI: 10.5535/arm.2019.43.2.204] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 10/25/2018] [Indexed: 12/16/2022] Open
Abstract
Objective To assess the clinical efficacy and safety of intra-articular injection of hyaluronic acid (HA) combined with polydeoxyribonucleotide (PDRN) in patients with knee osteoarthritis in comparison with that of HA alone. Methods The current single-center, prospective, randomized, double-blind, controlled study was conducted in 36 patients with knee osteoarthritis at our medical institution. All the eligible patients (n=30) were equally assigned to two treatment arms (trial group ‘HA+PDRN’ and control group ‘HA’). For efficacy assessment, the patients were evaluated for the visual analogue scale (VAS) scores, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Knee Society Scores (KSS), all of which served as efficacy outcome measures. We monitored time-dependent changes in efficacy outcome measures at baseline and 1, 3 and 6 months. Subsequently, we compared differences in changes in efficacy outcome measures at 6 months from baseline between the two groups. Moreover, we assessed the safety based on the treatment-emergent adverse events (TEAEs), adverse drug reactions (ADRs) and any other complications serving as safety outcome measures. Results There were significant differences in changes in the VAS scores, the WOMAC scores in all domains, except ‘Stiffness’, the total WOMAC scores, and the KSS scores in all the domains at 6 months from baseline between the two groups (p<0.05). In our series, there were no TEAEs, ADRs, and any other complications. Conclusion Intra-articular injections of HA combined with PDRN can also be considered in the treatment of knee osteoarthritis. However, further large-scale and multi-center studies are required to demonstrate the potential of the proposed combination.
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Affiliation(s)
- Seihee Yoon
- Department of Rehabilitation Medicine, Konkuk University Chungju Hospital, Konkuk University School of Medicine, Chungju, Korea
| | - Jung Joong Kang
- Department of Rehabilitation Medicine, Konkuk University Chungju Hospital, Konkuk University School of Medicine, Chungju, Korea
| | - Jungin Kim
- Department of Rehabilitation Medicine, Konkuk University Chungju Hospital, Konkuk University School of Medicine, Chungju, Korea
| | - Seunghun Park
- Department of Rehabilitation Medicine, Konkuk University Chungju Hospital, Konkuk University School of Medicine, Chungju, Korea
| | - Jong Moon Kim
- Department of Rehabilitation Medicine, Konkuk University Chungju Hospital, Konkuk University School of Medicine, Chungju, Korea
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Low-Concentration Oxygen/Ozone Treatment Attenuated Radiculitis and Mechanical Allodynia via PDE2A-cAMP/cGMP-NF- κB/p65 Signaling in Chronic Radiculitis Rats. Pain Res Manag 2018; 2018:5192814. [PMID: 30651902 PMCID: PMC6311849 DOI: 10.1155/2018/5192814] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 11/22/2018] [Indexed: 11/22/2022]
Abstract
Background Oxygen/ozone therapy is a minimally invasive technique for the treatment of radiculitis from lumbar disc herniation. This study aimed at investigating whether intrathecal administration of low-concentration oxygen/ozone could attenuate chronic radiculitis and mechanical allodynia after noncompressive lumbar disc herniation and at elucidating the underlying mechanisms. Methods First, we transplanted autologous nucleus pulposus into dorsal root ganglions to establish chronic radiculitis in rats. Then, filtered oxygen or oxygen/ozone (10, 20, or 30 μg/mL) was intrathecally injected on day 1 after surgery. The ipsilateral paw withdrawal thresholds (PWTs) to mechanical stimuli were tested daily with von Frey filaments. The expression of the tumor necrosis factor- (TNF-) α, interleukin- (IL-) 1β, IL-6, cyclic adenosine monophosphate (cAMP), cyclic guanosine monophosphate (cGMP), phosphodiesterase 2A (PDE2A), and nuclear factor- (NF-) κB/p65 in spinal dorsal horns was measured by enzyme-linked immunosorbent assay, polymerase chain reaction, and western blot on day 7 after surgery. Results Chronic radiculitis was established in rats. Intrathecal administration of 10 μg/mL, 20 μg/mL, or 30 μg/mL oxygen/ozone significantly attenuated the decreased mechanical PWTs, downregulated the overexpression of spinal TNF-α, IL-1β, and IL-6, and increased the expression of cGMP and cAMP in chronic radiculitis rats. In addition, the effects of treatment with 20 μg/mL oxygen/ozone were greater than the effects of the 10 μg/mL or 30 μg/mL doses. Moreover, intrathecal administration of 20 μg/mL oxygen/ozone reversed the increased levels of spinal PDE2A and NF-κB/p65 mRNA and protein expressions in rats with chronic radiculitis. Conclusion Intrathecal administration of low-concentration oxygen/ozone alleviated mechanical allodynia and attenuated radiculitis, likely by a PDE2A-cGMP/cAMP-NF-κB/p65 signaling pathway in chronic radiculitis rats.
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Lee WY, Park KD, Park Y. The effect of polydeoxyribonucleotide on the treatment of radiating leg pain due to cystic mass lesion in inner aspect of right sciatic foramen: A CARE compliant case report. Medicine (Baltimore) 2018; 97:e12794. [PMID: 30313106 PMCID: PMC6203516 DOI: 10.1097/md.0000000000012794] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
RATIONALE Radiating leg pain usually originates from the lumbar spine and occasionally from peripheral lesions. Here we report a case involving a patient with radiating pain in the right leg who exhibited 2 suspicious lesions, including 1 spinal lesion and 1 extraspinal cystic mass lesion, on magnetic resonance imaging. Polydeoxyribonucleotide sodium (PDRN) was recently noted as such a substitute. PDRN has anti-inflammatory effects, as it lowers the expression of inflammatory cytokines including interleukin-6 and tumor necrosis factor-alpha. PATIENT CONCERNS A 51-year-old man (weight, 93 kg; height, 168 cm) working as a bus driver presented at the pain clinic with continuous right buttock pain, radiating leg pain and a tingling sensation involving the calf and dorsum of the foot, since 1 week. DIAGNOSES He was definitively diagnosed using differential blocks, which revealed the cyst to be the actual cause of the pain. INTERVENTIONS Surgical resection was not feasible because of the position of the cyst; therefore, corticosteroid injection under ultrasonographic guidance was attempted. However, this provided short-term relief. Subsequently, a solution containing PDRN was injected around the piriformis muscle and repeated 3 more times at intervals of 2 weeks. OUTCOMES After PDRN injection, we conducted two follow-up monitoring every two months for 2 months. Last follow-up, the patient no longer complained of pain. this resulted in relatively long-term relief from pain. LESSONS The findings from this case suggest that PDRN is an effective alternative for steroids in patients with radiating leg pain, although its efficacy and safety needs to be evaluated in further large-scale studies.
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Affiliation(s)
- Woo Yong Lee
- Department of Anesthesiology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul
| | - Ki Deok Park
- Department of Rehabilitation Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon
| | - Yongbum Park
- Department of Rehabilitation Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea
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8
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Park D, Yu KJ, Cho JY, Woo SB, Park J, Lee Z, Kim JM. The effectiveness of 2 consecutive intra-articular polydeoxyribonucleotide injections compared with intra-articular triamcinolone for hemiplegic shoulder pain: A STROBE-complaint retrospective study. Medicine (Baltimore) 2017; 96:e8741. [PMID: 29145323 PMCID: PMC5704868 DOI: 10.1097/md.0000000000008741] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
The aim of this study was to investigate the effects of intra-articular injection of polydeoxyribonucleotide (PDRN), compared with intraarticular triamcinolone (TA) injection, in subacute stroke patients with hemiplegic shoulder pain (HSP).Participants were subacute stroke patients with HSP who had undergone 2 consecutive intra-articular injections of TA or PDRN.Numeric rating scale (NRS) and passive range of motion (PROM) of hemiplegic shoulder were evaluated until 4 weeks after 2nd injection.In the results, there were significant improvements in all PROM measures 2 weeks after the second injection, compared with pre-injection results, in both groups (P < .05). In the PDRN group, however, none of the PROM measures were significantly improved at 3 and 4 weeks after the second injection, compared with pre-injection results (P ≥ .05). When comparing pre-injection results with those at 4 weeks after the second injection, all PROM and NRS measures in the TA group were more improved than in the PDRN group, but this was not statistically significant (P ≥ .05).In conclusion, considering the systemic side effects of steroids, especially among patients with diabetes or metabolic syndrome, PDRN seems to be a worthwhile treatment option for HSP, although PDRN does not seem to have an equivalent persistence effects when compared with TA.
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Affiliation(s)
- Donghwi Park
- Department of Rehabilitation Medicine, Daegu Fatima Hospital
- Deparment of Phamacology, Kyungpook National Univeresity School of Medicine, Daegu, South Korea
| | - Kwang Jae Yu
- Department of Rehabilitation Medicine, Daegu Fatima Hospital
| | - Ju Young Cho
- Department of Rehabilitation Medicine, Daegu Fatima Hospital
| | - Seung Beom Woo
- Department of Rehabilitation Medicine, Daegu Fatima Hospital
| | - Junu Park
- Master of Science in Management, University of Liverpool, Liverpool, UK
| | - Zeeihn Lee
- Department of Rehabilitation Medicine, Daegu Fatima Hospital
| | - Jong Min Kim
- Department of Rehabilitation Medicine, Daegu Fatima Hospital
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Park D. Application of ultrasound-guided C5 nerve root block using polydeoxyribonucleotide in traumatic C5 nerve root injury caused by fracture of the articular process of the cervical spine: A case report. Medicine (Baltimore) 2017; 96:e8728. [PMID: 29145316 PMCID: PMC5704861 DOI: 10.1097/md.0000000000008728] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
RATIONALE Cervical nerve root injury is one of the complications of traumatic cervical spine fracture. Although one of the most effective treatments to reduce inflammation in nerve root injuries is the use of corticosteroids or nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids and NSAIDs can inhibit bone healing. So, when nerve injury accompanies bone fractures, corticosteroids and NSAIDs have limitations as therapeutic agents. However, polydeoxyribonucleotide (PDRN) may be useful in the treatment of neuropathy or musculoskeletal pain patients with contraindication of the use of corticosteroids because of its anti-inflammatory effect, as revealed in previous studies. To the best of our knowledge, there has been no report of treatment of traumatic nerve root injury due to an articular process fracture with an ultrasound-guided cervical nerve root block (NRB) using PDRN. PATIENTS CONCERNS A 54-year-old female patient with motor weakness of the left upper extremity and tingling sensation in the left neck and shoulder. DIAGNOSES:: traumatic C5 nerve root injury due to a fracture of the left articular process in the C4 spine. INTERVENTION Ultrasound-guided C5 NRB using PDRN. OUTCOMES Her motor weakness and sensory symptoms of the left upper extremity were significantly improved after treatment using an ultrasound-guided C5 NRB using PDRN. LESSONS Although it is impossible to draw a conclusion from a single case report, we suggest the ultrasound-guided NRB using PDRN could be a useful treatment for alleviating motor weakness and neuropathic pain caused by traumatic spinal nerve root injury in situations where corticosteroids cannot be used.
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Affiliation(s)
- Donghwi Park
- Department of Rehabilitation Medicine, Daegu Fatima Hospital
- Department of Pharmacology, Kyungpook National University, School of medicine, Daegu, Republic of Korea
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Mun JU, Cho HR, Bae SM, Park SK, Choi S., Seo MS, Lim YS, RN SHW, Kim YU. Effect of polydeoxyribonucleotide injection on pes anserine bursitis: A case report. Medicine (Baltimore) 2017; 96:e8330. [PMID: 29069005 PMCID: PMC5671838 DOI: 10.1097/md.0000000000008330] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
RATIONALE Pes anserine (PA) bursitis is an inflammatory condition of the medial knee. The PA bursa becomes more painful when infected, damaged, or irritated. Although various treatment options have been attempted to treat PA bursitis, optimal treatments are still debated. This study aims to investigate the effect of polydeoxyribonucleotide (PDRN) injection on reducing pain and inflammation in a patient presenting with PA bursitis. PATIENT CONCERNS A 50-year-old female patient was admitted to our pain clinic with symptoms of tenderness and pain over the medial knee. Physical examination revealed the pain to be located over the proximal medial tibia at the insertion of the conjoined tendons of the PA. The knee had lost its range of movement and strength, and resisted knee flexion. DIAGNOSES She was diagnosed as having PA bursitis. INTERVENTIONS Ultrasound guided PA bursa injection was carried out. OUTCOMES Follow-up for the patient was more than eight months. She showed good improvement in PA bursitis without any complications. LESSONS This is the first successful report of successful PDRN injection for PA bursa.
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Affiliation(s)
- Jong-Uk Mun
- Department of Orthopedic Surgery, Changwon Gyeongsang National University Hospital, Incheon
| | - Hyung R. Cho
- Department of Anesthesiology and Pain Medicine, Myongji Hospital, College of Medicine, Seonam University, Goyang
| | - Sae M. Bae
- Department of Anesthesiology and Pain Medicine, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Incheon
| | - Soo K. Park
- Department of Anesthesiology and Pain Medicine, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Incheon
| | - Soo .l Choi
- Department of Anesthesiology and Pain Medicine, Catholic Kwandong University of Korea College of Medicine, International ST. Mary‘s Hospital, Incheon
| | - Mi S. Seo
- Department of Anesthesiology and Pain Medicine, Catholic Kwandong University of Korea College of Medicine, International ST. Mary‘s Hospital, Incheon
| | - Young S. Lim
- Department of Anesthesiology and Pain Medicine, Catholic Kwandong University of Korea College of Medicine, International ST. Mary‘s Hospital, Incheon
| | - Soo H. Woo RN
- Department of Nursing, Kyung-In Women‘s University, Incheon, Republic of Korea
| | - Young U. Kim
- Department of Anesthesiology and Pain Medicine, Catholic Kwandong University of Korea College of Medicine, International ST. Mary‘s Hospital, Incheon
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