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Hypertonic dextrose injection (prolotherapy) for knee osteoarthritis: Long term outcomes

Hypertonic dextrose injection (prolotherapy) for knee osteoarthritis: Long term outcomes Hypertonic dextrose injection (prolotherapy) for knee osteoarthritis: Long term outcomes
Hypertonic dextrose injection (prolotherapy) for knee osteoarthritis: Long term outcomes Hypertonic dextrose injection (prolotherapy) for knee osteoarthritis: Long term outcomes

Knee osteoarthritis (OA) is a common, debilitating chronic disease. 

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Key take away

Prolotherapy is an injection of an irritant solution (often a form of sugar called dextrose) into joints, ligaments and tendons. A typical treatment program involves 15 to 20 shots given per month for three to four months, followed by occasional, as-needed shots. This article explained the usefulness of the prolotherapy for the long term benefits for knee osteoarthritis. 

Background

Knee osteoarthritis (OA) is a common, debilitating chronic disease. Prolotherapy is an injection therapy for chronic musculoskeletal pain. Recent 52-week randomized controlled and open label studies have reported improvement of knee OA-specific outcomes compared to baseline status, and blinded saline control injections and at-home exercise therapy (p<0.05). However, long term effects of prolotherapy for knee OA are unknown. We therefore assessed long-term effects of prolotherapy on knee pain, function and stiffness among adults with knee OA.

Design: Post clinical-trial, open-label follow-up stud. Outpatient; adults with mild-to-severe knee OA completing a 52-week prolotherapy study were enrolled.

Method

Participants received 3-5 monthly interventions and were assessed using the validated Western Ontario McMaster University Osteoarthritis Index, (WOMAC, 0-100 points), at baseline, 12, 26, 52 weeks, and 2.5 years.

Result

65 participants (58±7.4 years old, 38 female) received 4.6±0.69 injection sessions in the initial 17-week treatment period. They reported progressive improvement in WOMAC scores at all-time points in excess of minimal clinical important improvement benchmarks during the initial 52-week study period, from 13.8±17.4 points (23.6%) at 12 weeks, to 20.9±2.8 points, (p<0.05; 35.8% improvement) at 2.5±0.6 years (range 1.6-3.5 years) in the current follow-up analysis. Among assessed covariates, none were predictive of improvement in the WOMAC score.

Conclusion

Prolotherapy resulted in safe, significant, progressive improvement of knee pain, function and stiffness scores among most participants through a mean follow-up of 2.5 years and may be an appropriate therapy for patients with knee OA refractory to other conservative care.

Source:

Complement Ther Med. 2015 Jun;23(3):388-95

Article:

Hypertonic dextrose injection (prolotherapy) for knee osteoarthritis: Long term outcomes

Authors:

Rabago D et al.

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