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Abstract
Objectives To determine whether there is similarity between tetradecyl sulfate and polidocanol in stabilising a joint from dislocating in patients with Ehlers-Danlos syndrome (EDS).
Method A retrospective analysis of patients with EDS in a sole-practice clinic in New Zealand. Patients must have had the diagnosis of EDS, had easily dislocatable joints, had treatment and at least 3 months’ follow-up. 0.11% tetradecyl sulfate solution, or 0.25% polidocanol solution, was injected to ligament attachments (enthesis) on the side of the joints where they dislocated. Patients were deemed successfully treated if their affected joints were no longer dislocated over a minimum of 3 months’ follow-up (out to 3 years).
Results Of 250 patients at the time of the study, 46 fitted the criteria. There were 37 treated with tetradecyl sulfate and nine with polidocanol. For the tetradecyl group there were a total of 305 injections around 97 joints: mean 3.1, range 1–22, median 2. For the polidocanol group there were 36 injections around 19 joints: mean 1.9, range 1–8, median 2. The difference of means between group 1 (tetradecyl) and group 2 (polidocanol) is 1.2, CIs 0.34 to 2.98. All patients had no further dislocations of treated joints unless they had a major new injury (two patients).
Conclusion There was no difference between the two groups for stabilising joints from dislocating. These two agents appear promising for treating patients with recurrent joint dislocations in the setting of EDS. Prospective multicentre randomised controlled trials are needed to confirm these data.
- joint dislocation
- Ehlers-Danlos syndrome
- prolotherapy
- tetradecyl sulfate
- polidocanol
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Footnotes
Contributors FB planned the retrospective review, conducted the analysis and reported the work described in the article.
Funding The author has not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests FB reports personal fees from Rheumatology and Musculoskeletal Clinic during the conduct of the study.
Patient consent for publication Not required.
Ethics approval The Health and Disability Ethics Committees, Wellington, New Zealand, determined that formal ethics approval is not needed for this retrospective study.
Provenance and peer review Not commissioned; internally peer reviewed.
Data sharing statement These data are available from the author on reasonable request.