Regenerative Medicine
Esha Jain, MD
Medical Resident
Medstar Georgetown National Rehabilitation Hospital
Washington, District of Columbia, United States
Aakash Thakral, MD
Pain Medicine Physician
International Spine, Pain, and Performance Center
Washington DC, District of Columbia, United States
Esha Jain, MD
esha.jain@hotmail.com
Washington, District of Columbia, United States
An 18-year-old dancer with persistent genicular neuralgia has sustained pain relief after undergoing two rounds of genicular nerve neuroprolotherapy.
Case Description:
An 18-year-old female dancer presented with two months of anterior right knee pain following a mislanded aerial jump, limiting her ability to compete with her dance team. She tried multiple over-the-counter pain medications and received an infrapatellar bursa injection with orthopedic surgery without relief. MRI was overall unrevealing other than mild focal soft tissue edema anterior to the tibial tuberosity without bursitis and minimal edema in Hoffa’s fat pad. She continued to experience burning, stabbing anterior knee pain and was referred for interventional pain management, with genicular nerve radiofrequency ablation suggested. Ultimately, the decision was made to proceed with neuroprolotherapy injections to reduce inflammation around the genicular nerves and potentially provide targeted, long-term pain control. The patient underwent two rounds of genicular nerve neuroprolotherapy under ultrasound guidance four weeks apart. She experienced 85% pain relief after the first round of injections and near-complete pain relief after the second round. Neuroprolotherapy can be a promising treatment for neuropathic knee pain. It has been shown to reduce neurogenic inflammation by disrupting pain-signalling pathways and promoting tissue repair. This can lead to long-term pain relief and improved function. Neuroprolotherapy may also be favorable as a non-invasive, regenerative modality for pain control, avoiding nerve ablation or repeated steroid injections. While emerging studies report beneficial results, research remains limited, particularly in young patients, with little standardization of protocols.
Discussions:
Conclusions: Genicular nerve prolotherapy can be an effective treatment to reduce inflammation and pain, and can be considered as an alternative to neurolysis to achieve long-term pain control. This patient responded well to neuroprolotherapy. She competed in national championships and was able to join her college dance team months later, with sustained relief following two rounds of neuroprolotherapy.
