Effects of Dextrose Prolotherapy in Rotator Cuff Disease

Inclusion Criteria: * Age between 30 and 65 years * Shoulder pain lasting longer than 3 months * Resistance to conservative treatment for at least 3 months * Diagnosis of rotator cuff disease confirmed by clinical examination and magnetic resonance imaging (MRI) Exclusion Criteria: * Presence of rheumatic disease or other systemic inflammatory diseases * Uncontrolled diabetes mellitus * Local or systemic infection * History of previous shoulder surgery * Bleeding tendency (acquired or hereditary) or use of anticoagulant therapy with INR \>2 * Shoulder injection within the previous 8 weeks * Allergy to local anesthetics * Passive shoulder abduction \<100° or external rotation \<25° * Rotator cuff calcification with diameter \>0.8 cm detected on radiography or ultrasonography * Presence of severe comorbid disease