Chondrogenic Effect of Intra-articular Hypertonic-Dextrose (Prolotherapy) in Severe Knee Osteoarthritis.
Knee osteoarthritis is a major risk factor which can affect the people of any age or it may also sbe hereditry. In the recent studies, it was shown that chondrogenic effects of the intra-articular hypertonic dextrose or also known as prolotherapy has been described with the clinical measures. Dextrose injection is reported to improve the knee osteoarthritis in all age group people.
Biological and clinical effects of intra-articular hypertonic dextrose injections (prolotherapy) in painful knee osteoarthritis were evaluated. 10ml of intra-articular injection containing 12.5% of dextrose was injected in 6 participants (1 female and 5 male). Post treatment area of cartilage was evaluated using hematoxylin and eosin with Safranin- O statins which were self reported using the Western Ontario McMaster University Osteoarthritis Index (WOMAC, 0-100 points). sNine standardized medical condyle zones in each of 6 participants were evaluated by 3 arthroscopy readers (total 54 zones were evaluated per reader).
WOMAC composite scores of 57.5 points were observed in six participants with median age of 71 years. 6 dextrose injections were given to 7.75 months for 9 years of pain duration. In 19 of 54 zone comparions, 3 readers agreed that the post treatment zone showed cartilage growth compared with the pretreatment zone. Metabolically active cartilage with variable cellular organization, fiber parallelism and cartilage typing patterns which are consistent fibro and hyaline like cartilage were seen in biopsy. Median WOMAC scores were improved to 13 points when compared with baseline status. However, self-limited soreness after methylene blue instillation were observed.
In participants with symptomatic grade IV Knee Osteoarthrtis, clinically positive and chondrogenic effects were seen after the prolotherapy administered with hypertonic dextrose injection. Findings suggested that the disease modifying effects are needed for confirmation in controlled studies. Minimally invasive arthroscopy (single-compartment with single portal) enabled the collection of robust intra-articular data.