• Nuralam Sam, Irawan Yusuf, Irfan Idris, Endy Adnan, Ratna Darjanti Haryadi, Firdaus Hamid, Andry Usman, Muhammad Phetrus Johan, Andi Alfian Zainuddin, and Agussalim Bukhari.
• Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.
• Medicine (Baltimore). 2023 Jul 28; 102 (30): e34356e34356.

ObjectiveTo determine the effect of prolotherapy on functional outcome changes, along with ratio of matrix metalloproteinase-1 (MMP-1)/tissue inhibitor matrix metalloproteinase-1 (TIMP-1) as an indicator of tissue repair in the glenohumeral joint in frozen shoulder patients.DesignSingle-blinded randomized controlled trial.Subjects/PatientsParticipants with frozen shoulder.MethodsThe prolotherapy group is the study group, and the normal saline (NS) group is the control group. Each group was given injections at weeks 0, 2, 4, and 6. Level of biomarker levels was measured at week 6 and week 12 after there. Functional outcomes were measured at weeks 0, 6, and 12.ResultsA significant difference in week 6 and week 12 was demonstrated in the ratio of MMP-1/TIMP-1 level between the prolotherapy group and the normal saline group (P value = .002). Both groups performed well regarding the Numerical Rating Scale score and functional outcome. Compared to the normal saline group, prolotherapy changed the mean range of motion in flexion and internal rotation.ConclusionProlotherapy is considered to play a role in repairing cartilage based on biomarker assessment, particularly the ratio of MMP-1/TIMP-1-prolotherapy effectiveness in improving functional outcome and Numerical Rating Scale score.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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