Dextrose prolotherapy – injection therapy using a sugar solution to relieve musculoskeletal pain – offers sustained improvement of pain, function and stiffness for patients with knee osteoarthritis.
Ninety adults who had at least three months of painful knee osteoarthritis were randomized to receive dextrose prolotherapy injections, saline injections or at-home exercise.
Injections were done at one, five and nine weeks with as-needed additional treatments at weeks 13 and 17. Researchers found patients receiving dextrose prolotherapy improved more (P < .05) at 52 weeks than patients receiving saline and exercise as measured by their composite score on the Western Ontario McMaster University Osteoarthritis Index (score change: 15.3 ± 3.5 vs. 7.6 ± 3.4, and 8.2 ± 3.3 points, respectively) and Knee Pain Scale.
In terms of functionality, dextrose patients reported significantly better function than both saline and exercise participants for a change of 16.25 compared with 5.45 and 7.31 points respectively, at 52 weeks. Individual knee pain scores also improved more in the prolotherapy group (P = .05).
Patient satisfaction with prolotherapy was high, and no adverse events were reported. With most of the population showing radiographic evidence of osteoarthritis by the age of 65 years, the authors call for future research to compare the effectiveness of prolotherapy for knee osteoarthritis with that of other current therapy, including intraarticular corticosteroid and hyaluronic acid injections, in a larger effectiveness trial that includes biomechanical and imaging outcomes.
Dextrose Prolotherapy for Knee Osteoarthritis: A Randomized Controlled Trial. By David Rabago, MD, et al