Efficacy of Intra-Articular Hypertonic Dextrose (Prolotherapy) for Knee Osteoarthritis: A Randomized Controlled Trial

Abstract

PURPOSE To test the efficacy of intra-articular hypertonic dextrose prolotherapy (DPT) vs normal saline (NS) injection for knee osteoarthritis (KOA). METHODS A single-center, parallel-group, blinded, randomized controlled trial was conducted at a university primary care clinic in Hong Kong. Patients with KOA (n = 76) were randomly allocated (1:1) to DPT or NS groups for injections at weeks 0, 4, 8, and 16. The primary outcome was the Western Ontario McMaster University Osteoarthritis Index (WOMAC; 0-100 points) pain score. The secondary outcomes were the WOMAC composite, function and stiffness scores; objectively assessed physical function test results; visual analogue scale (VAS) for knee pain; and EuroQol-5D score. All outcomes were evaluated at baseline and at 16, 26, and 52 weeks using linear mixed model. RESULTS Randomization produced similar groups. The WOMAC pain score at 52 weeks showed a difference-indifference estimate of-10.34 (95% CI,-19.20 to-1.49, P = 0.022) points. A similar favorable effect was shown on the differencein-difference estimate on WOMAC function score of-9.55 (95% CI,-17.72 to-1.39, P = 0.022), WOMAC composite score of-9.65 (95% CI,-17.77 to-1.53, P = 0.020), VAS pain intensity score of-10.98 (95% CI,-21.36 to-0.61, P = 0.038), and EuroQol-5D VAS score of 8.64 (95% CI, 1.36 to 5.92, P = 0.020). No adverse events were reported. CONCLUSION Intra-articular dextrose prolotherapy injections reduced pain, improved function and quality of life in patients with KOA compared with blinded saline injections. The procedure is straightforward and safe; the adherence and satisfaction were high.

The therapeutic effect of intra-articular facet joint injection with normal saline as a comparator for chronic low back pain: a systematic review and meta-analysis

“…One hypothesis is the dilution of inflammatory mediators which resulted in pain relief. 34 A study attempted to explore the potential of other mechanisms including the osmolality effect and sodium concentration, but no sufficient evidence to support the hypothesis. 35 For facet joint, the first saline injection which resulted in pain relief was hypertonic saline.…”

Las inyecciones intra-articulares de solución salina tienen similar eficacia a las de plasma rico en plaquetas, ácido hialurónico o corticoides para el alivio del dolor en pacientes con artrosis de cadera: meta-análisis en red

“…Estudios experimentales han documentado que las soluciones hiperosmolares como la solución salina y la dextrosa hipertónica protegen a los condrocitos de las lesiones mecánicas 4 y bloquean los receptores TRPV1, favoreciendo la reparación del tejido. Nuestro grupo de trabajo tiene particular experiencia con el uso de dextrosa hipertónica, con resultados similares a los documentados en este meta-análisis en red 5,6 respecto de la solución salina.…”

Manfaat Proloterapi pada Osteoartritis Lutut

“…Namun, beberapa hasil penelitian telah menyatakan bahwa parasetamol (asetaminofen) hanya memberikan manfaat sedikit dalam penanganan nyeri OA lutut pada seseorang. 5 Walaupun obat anti inflamasi non stereoid (OAINS) juga efektif untuk menghilangkan nyeri, namun keamanan akan penggunaan obat ini untuk jangka panjang perlu diperhatikan. Pada dasarnya OAINS bekerja untuk mengurangi nyeri dan bengkak pada jaringan.…”

“…Sendi akan lebih cepat hancur yang tentunya tidak sesuai dengan yang diharapkan sehingga pengobatan secara tradisional telah ditinggalkan dan dianggap tidak efektif. 5 Oleh karena itu dibutuhkan suatu cara pengobatan baru, lebih efektif, dengan biaya yang lebih terjangkau dalam penyembuhan penyakit muskuloskeletal, salah satunya ialah OA pada lutut. 7 Pengobatan terbaru yang sekarang telah memberikan hasil yang cukup bermakna serta membawa hasil yang jauh lebih bermanfaat di bidang kedokteran ialah proloterapi.…”