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 6 publications

(14 citation statements)

References 18 publications

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“…Clinical studies evaluating prolotherapy's efficacy have yielded mixed results. While some trials report reduced pain and improved function, others show limited benefit compared to placebo [7]. The variability in study designs, patient populations, and injection techniques may contribute to inconsistent outcomes.…”

Section: Review Methodologymentioning

confidence: 99%

“…This procedure involves injecting a local anesthetic and a corticosteroid near the genicular nerves, which provide pain sensation to the knee, either under ultrasound or fluoroscopic guidance [6]. Only three of the four genicular nerves are blocked as blocking the inferolateral genicular nerve can cause a foot drop [7]. This procedure is well tolerated and can provide temporary relief of knee pain for approximately one to three months.…”

Section: Introductionmentioning

confidence: 99%

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Interventional Techniques for the Management of Knee Osteoarthritis: A Literature Review

Malik,

Camp,

Chan

et al. 2023

Cureus

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Osteoarthritis of the knee is a prevalent condition that causes pain, discomfort, and disability that can severely impact the quality of life. This literature review aims to review the various interventional pain management techniques available to treat knee osteoarthritis. It analyzes the efficacy of various interventions such as intra-articular corticosteroids, prolotherapy, viscosupplementation, platelet-rich plasma, and genicular nerve blocks with radiofrequency ablation or cryoneurolysis. We searched databases for studies published in the past 20 years. A total of 37 articles were included. The literature supports the idea that a comprehensive treatment plan consisting of the various aforementioned techniques can provide relief for patients while delaying or avoiding joint replacement surgery.

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Section: Review Methodologymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Interventional Techniques for the Management of Knee Osteoarthritis: A Literature Review

Malik,

Camp,

Chan

et al. 2023

Cureus

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“…In addition, another systematic review including 10 articles indicated that dextrose prolotherapy has been shown to have better therapeutic effects on pain in patients with OA compared to exercise, and that it has similar effects to platelet-rich plasma and steroid injections ( 115 ). However, although the latest systematic review showed that dextrose prolotherapy is beneficial in reducing pain and improving function in patients with knee OA, there is a high risk of bias and heterogeneity in the results ( 116 , 117 ). While individuals may experience short-term relief, questions remain about the long-term durability of the treatment.…”

Section: Potential Therapeutic Substances For Oa That Affect Glucose ...mentioning

confidence: 99%

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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“…The comprehensive review of literature on prolotherapy highlights its potential benefits in managing OA symptoms, particularly in the knee joint. Despite the lack of homogeneity in studies, recent trials have demonstrated that dextrose prolotherapy can effectively reduce pain scores and improve stiffness, function, and quality of life in patients with KOA 20–25 . Dextrose, a cost‐effective and readily available substance, has gained prominence as an injection‐based therapeutic option for managing chronic painful musculoskeletal conditions.…”

Section: Introductionmentioning

confidence: 99%

The effect of dextrose prolotherapy on patients diagnosed with knee osteoarthritis: A comprehensive systematic review and meta‐analysis of interventional studies

Khateri,

Nejad,

Kazemi

et al. 2024

Health Science Reports

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Background and AimsThe primary objective of this systematic review and meta‐analysis was to assess the impact of dextrose prolotherapy on individuals diagnosed with knee osteoarthritis (KOA).MethodsTo conduct a thorough investigation, a variety of leading international databases were checked, including PubMed (Medline), Scopus, Web of Sciences, EMBASE (Elsevier), ClinicalTrials.gov, and the Cochrane Library. The search covered a period from January 2000 to the end of June 2023, which facilitated the collection of relevant studies.ResultsThe findings of the study revealed that when the studies utilizing the Western Ontario McMaster Universities Index tool (WOMAC) were combined, patients with KOA who received prolotherapy experienced an improvement in function compared with those who received other treatments (SMD: 0.20; 95% Confidence Interval [1]: −0.11, 0.51; p value SMD = 0.221; I2: 78.49%; pheterogeneity < 0.001). Additionally, there was a decrease in mean pain and stiffness among patients who received prolotherapy compared with those who received other treatments or a placebo [(SMD: −0.95; 95% CI: ‐1.14, −0.76; p value SMD < 0.001; I2: 59.35%; pheterogeneity = 0.070) and (SMD: −0.21; 95% CI: −0.32, −0.10; p value SMD < 0.001; I2: 88.11%; pheterogeneity < 0.001)]. Furthermore, based on the Visual Analog Scale (VAS) score, there was a reduction of 0.81 units out of 10 in mean pain for patients with KOA who received prolotherapy (SMD: −0.81; 95% CI: −5.63, 4.10; p value SMD = 0.693; I2: 48.54%; pheterogeneity = 0.08).ConclusionDrawing from the data analysis performed in this meta‐analysis, it is apparent that dextrose prolotherapy exhibits promising effectiveness in reducing joint pain and stiffness, as well as improving functional performance in individuals suffering from KOA. Furthermore, it is recommended that forthcoming studies incorporate follow‐up periods to guide decisions concerning the duration of prolotherapy's effects.

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

Cited by 6 publications

References 18 publications

Interventional Techniques for the Management of Knee Osteoarthritis: A Literature Review

Interventional Techniques for the Management of Knee Osteoarthritis: A Literature Review

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

The effect of dextrose prolotherapy on patients diagnosed with knee osteoarthritis: A comprehensive systematic review and meta‐analysis of interventional studies

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