Comparing dextrose prolotherapy with other substances in knee osteoarthritis pain relief: A systematic review

Cortez, Vitor Santos; Moraes, Walter Augusto; Taba, João Victor; Condi, Alberto; Suzuki, Milena Oliveira; Nascimento, Fernanda Sayuri do; Pipek, Leonardo Zumerkorn; Mattos, Vitoria Carneiro de; Torsani, Matheus Belloni; Meyer, Alberto; Hsing, Wu Tu; Iuamoto, Leandro Ryuchi

doi:10.1016/j.clinsp.2022.100037

Cited by 5 publications

(1 citation statement)

References 18 publications

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“…Systematic review and network meta-analysis (NMA) studies have investigated the relative efficacy of the following IAI agents, analyzed in pairs: CSs [ 11 , 12 , 13 , 14 , 15 , 16 ], HA [ 12 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 ], PRP [ 11 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 23 , 24 , 25 ], plasma rich in growth factor (PRGF) [ 12 , 13 ], botulinum neurotoxin type A (BoNTA) [ 12 , 18 , 23 ], ozone (OZ) [ 12 , 16 , 20 , 21 ], dextrose prolotherapy (DxTP) [ 18 , 23 ], MSCs [ 12 , 14 , 24 , 25 , 26 ], stromal vascular fraction of adipose tissue (SVF) [ 12 , 25 , 26 ], and autologous conditioned serum (ACS) [ 12 , 23 , 25 ]. However, none of these IAI agents have been comprehensively compared with others in a single NMA study, and thus, the overall relative efficacy of each remains unclear [ …”

Section: Introductionmentioning

confidence: 99%

Comparative Efficacy of Intra-Articular Injection, Physical Therapy, and Combined Treatments on Pain, Function, and Sarcopenia Indices in Knee Osteoarthritis: A Network Meta-Analysis of Randomized Controlled Trials

Liao

Chen

Huang

et al. 2023

IJMS

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Knee osteoarthritis (KOA) is associated with a high risk of sarcopenia. Both intra-articular injections (IAIs) and physical therapy (PT) exert benefits in KOA. This network meta-analysis (NMA) study aimed to identify comparative efficacy among the combined treatments (IAI+PT) in patients with KOA. Seven electronic databases were systematically searched from inception until January 2023 for randomized controlled trials (RCTs) reporting the effects of IAI+PT vs. IAI or PT alone in patients with KOA. All RCTs which had treatment arms of IAI agents (autologous conditioned serum, botulinum neurotoxin type A, corticosteroids, dextrose prolotherapy (DxTP), hyaluronic acid, mesenchymal stem cells (MSC), ozone, platelet-rich plasma, plasma rich in growth factor, and stromal vascular fraction of adipose tissue) in combination with PT (exercise therapy, physical agent modalities (electrotherapy, shockwave therapy, thermal therapy), and physical activity training) were included in this NMA. A control arm receiving placebo IAI or usual care, without any other IAI or PT, was used as the reference group. The selected RCTs were analyzed through a frequentist method of NMA. The main outcomes included pain, global function (GF), and walking capability (WC). Meta-regression analyses were performed to explore potential moderators of the treatment efficacy. We included 80 RCTs (6934 patients) for analyses. Among the ten identified IAI+PT regimens, DxTP plus PT was the most optimal treatment for pain reduction (standard mean difference (SMD) = −2.54) and global function restoration (SMD = 2.28), whereas MSC plus PT was the most effective for enhancing WC recovery (SMD = 2.54). More severe KOA was associated with greater changes in pain (β = −2.52) and WC (β = 2.16) scores. Combined IAI+PT treatments afford more benefits than do their corresponding monotherapies in patients with KOA; however, treatment efficacy is moderated by disease severity.

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Section: Introductionmentioning

confidence: 99%

Comparative Efficacy of Intra-Articular Injection, Physical Therapy, and Combined Treatments on Pain, Function, and Sarcopenia Indices in Knee Osteoarthritis: A Network Meta-Analysis of Randomized Controlled Trials

Liao

Chen

Huang

et al. 2023

IJMS

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The role of targeting glucose metabolism in chondrocytes in the pathogenesis and therapeutic mechanisms of osteoarthritis: a narrative review

Pi,

Zeng,

Zeng

et al. 2024

Front. Endocrinol.

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Osteoarthritis (OA) is a common degenerative joint disease that can affect almost any joint, mainly resulting in joint dysfunction and pain. Worldwide, OA affects more than 240 million people and is one of the leading causes of activity limitation in adults. However, the pathogenesis of OA remains elusive, resulting in the lack of well-established clinical treatment strategies. Recently, energy metabolism alterations have provided new insights into the pathogenesis of OA. Accumulating evidence indicates that glucose metabolism plays a key role in maintaining cartilage homeostasis. Disorders of glucose metabolism can lead to chondrocyte hypertrophy and extracellular matrix degradation, and promote the occurrence and development of OA. This article systematically summarizes the regulatory effects of different enzymes and factors related to glucose metabolism in OA, as well as the mechanism and potential of various substances in the treatment of OA by affecting glucose metabolism. This provides a theoretical basis for a better understanding of the mechanism of OA progression and the development of optimal prevention and treatment strategies.

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Prolotherapy in Musculoskeletal Disorders, Guideline for Orthopedic Application

Mafhoumi,

Nabian,

Mehrpour

2023

OJRM

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Comparing dextrose prolotherapy with other substances in knee osteoarthritis pain relief: A systematic review

Cited by 5 publications

References 18 publications

Comparative Efficacy of Intra-Articular Injection, Physical Therapy, and Combined Treatments on Pain, Function, and Sarcopenia Indices in Knee Osteoarthritis: A Network Meta-Analysis of Randomized Controlled Trials

Comparative Efficacy of Intra-Articular Injection, Physical Therapy, and Combined Treatments on Pain, Function, and Sarcopenia Indices in Knee Osteoarthritis: A Network Meta-Analysis of Randomized Controlled Trials

The role of targeting glucose metabolism in chondrocytes in the pathogenesis and therapeutic mechanisms of osteoarthritis: a narrative review

Prolotherapy in Musculoskeletal Disorders, Guideline for Orthopedic Application

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