Injection therapy for treatment of osteitis pubis
| Article | Subjects | Age (years) | Sport | Type of injection | No of injections | Return to play | Failures/complications |
|---|---|---|---|---|---|---|---|
| Holt | 10 M 2 F | Mean 20 | Football9 | 1% Lidocaine 1 ml | Chronic group: (16 weeks symptoms) eight athletes, mean 1.75 injections | Chronic group: seven out of eight athletes, mean 10 weeks | Chronic group: One athlete remained symptomatic after two injections and inguinal herniorrhaphy Acute group: none |
| Soccer2 | 0.25% Bupivacaine 1 ml | Acute group: (7–10 days symptoms) three athletes, mean one injection | Acute group: three out of three athletes, all within 2 weeks | ||||
| Ice hockey13 | 4 mg Dexamethasone 1 ml | ||||||
| Diving4 | |||||||
| Batt | 2 M | Mean 22 | Football13 | Betamethasone (strength/amount not specified) | Mean 1.5 injections | Mean 10 weeks | Both athletes with/recurrent symptoms months later: Case 1: improved following prednisone taper and indomethacin Case 2: improved following prednisone taper and second corticosteroid injection |
| O'Connell | 14 M 2 F | Mean 28.4 | High-level athletes (not specified) | 0.5% Bupivacaine 1 ml Methylprednisolone 20 mg | Mean one injection | Within 48 h: 14 out of 16 athletes with partial symptom improvement and resumed sport | One athlete required two additional injections of bupivacaine only over 6-month period. One athlete with/persistent pain referred for pubic symphysis fusion |
| At 2 weeks: 10 out of 16 noted continued pain relief | |||||||
| At 2 and 6 months: 5 out of 16 completely symptom free | |||||||
| Topol | 24 M | Mean 25 | Rugby11 Soccer13 | Prolotherapy of eight injection sites across pubic ramus, ischium and pubic symphysis with monthly injections of 12.5% dextrose, 0.5% lidocaine | Mean 2.8 injection sites | 11 athletes (1–2 injections): within 6 weeks 11 out of 13 athletes (>2 injections): within 3 months | Two non-responders unable to return to sport |