Prolotherapy for knee osteoarthritis using hypertonic dextrose vs other interventional treatments: systematic review of clinical trials

Abstract

Background: To evaluate the efficacy and safety of prolotherapy with hypertonic dextrose in patients with knee osteoarthritis. A systematic search was performed in electronic databases including PUBMED, SCIELO, DIALNET and Google Scholar. Main body:We searched for randomized clinical trials that evaluated therapeutic interventions in patients with knee osteoarthritis. These trials compared the effect of intra-articular and / or extra-articular infiltrations of hypertonic dextrose vs the effect of intra-articular and / or extra-articular infiltrations of other substances or some interventional procedure application, via assessing pain, physical function and secondary effects and / or adverse reactions. Ten randomized clinical trials were included in this systematic review, the total sample size comprised 328 patients treated with hypertonic dextrose (prolotherapy) vs 348 controls treated with other infiltrations such as local anesthetics, hyaluronic acid, ozone, platelet-rich plasma or interventional procedures like radiofrequency. Conclusions: In terms of pain reduction and function improvement, prolotherapy with hypertonic dextrose was more effective than infiltrations with local anesthetics, as effective as infiltrations with hyaluronic acid, ozone or radiofrequency and less effective than PRP and erythropoietin, with beneficial effect in the short, medium and long term. In addition, no side effects or serious adverse reactions were reported in patients treated with hypertonic dextrose. Although HDP seems to be a promising interventional treatment for knee OA, more studies with better methodological quality and low risk of bias are needed to confirm the efficacy and safety of this intervention.

Pain Trajectories in Knee Osteoarthritis—A Systematic Review and Best Evidence Synthesis on Pain Predictors

“…This issue also plays a key role in the scientific research field, considering the importance of pain progression in the evaluation of the effectiveness of treatments, which should be compared to the normal disease progression pattern [ 14 ]. The identification of a clinically relevant endpoint is particularly important for promising new drugs, targeting the early phases of OA and aimed at modifying the progression of the disease [ 7 , 15 , 16 ]. Recently, the opportunity to follow-up communities of patients with knee OA made it possible to document the evolution of this disease and its symptoms [ 17 ].…”

Manfaat Proloterapi pada Osteoartritis Lutut

“…Pada penelitian ini didapatkan 10 literatur yang memenuhi kriteria inklusi dan eksklusi serta merupakan penelitian crosssectional, dengan penelitinya sebagai berikut: Naseer ZA et al tahun 2017, 4 Sit RWS et al tahun 2020, 5 Rabago D et al tahun 2010, 8 Hauser RA dan Cukla JJ tahun 2009, 9 Reeves DK tahun 2000, 10 Reeves DK et al tahun 2016, 11 Sekeon SAS et al tahun 2019, 12 Hauser RA dan Hauser MA tahun 2011, 13 Wheaton MT dan Jensen N tahun 2011, 14 dan Arias-Vasquez P et al tahun 2019. 15 Literatur pertama oleh Naseer et al 4 pada tahun 2017 telah dipublikasikan ke dalam Insall & Scott Surgery of the Knee dengan judul Nonoperative treatment of knee arthritis. Berbagai macam tatalaksana yang dapat dilakukan pada kasus OA lutut, dan proloterapi merupakan salah satu metode yang sudah digunakan sejak 70 tahun silam.…”

“…Literatur ke-10 oleh Arias-Vasquez et al 15 pada tahun 2019 dan dipublikasikan dalam Advances in Rheumatology (London, United Kingdom) dengan judul Prolotherapy for knee osteoarthritis using hypertonic dextrose vs other interventional treatments: systematuc review of clinical trials. Pada jurnal ini terdapat berbagai perbandingan penggunaan injeksi proloterapi dengan dekstorsa hipertonik dan berbagai metode serta proliferan lainnya.…”

“…Arias-Vasquez et al 15 membandingkan penggunaan injeksi proloterapi dengan dekstrosa hipertonik dan berbagai metode serta proliferan lainnya. Hasil penelitiannya mendapatkan bahwa penggunaan dekstrosa hipertonik lebih efektif dalam mengurangi nyeri dan peningkatan fungsi jaringan dibandingkan berbagai proliferan lainnya dengan anastesi lokal, serta memiliki manfaat jangka panjang.…”

Dextrose prolotherapy in knee osteoarthritis: A systematic review and meta-analysis

“…12,13 This systematic review aimed to re-evaluate randomized studies examining efficacy of dextrose prolotherapy compared against controls or other active interventions in the management of knee OA, in light of findings from a spate of new trials that have been published in this field since the last systematic review. 7…”