Hypertonic dextrose injection (prolotherapy) for knee osteoarthritis: Long term outcomes.

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Hypertonic dextrose injection (prolotherapy) for knee osteoarthritis: Long term outcomes.
Key Take-Away: 

Prolotherapy is an injection of an irritant solution (often a form of sugar called dextrose) into joints, ligaments and tendons. A typical treatment program involves 15 to 20 shots given per month for three to four months, followed by occasional, as-needed shots. This article explained the usefulness of the prolotherapy for the long term benefits for knee osteoarthritis.

Knee osteoarthritis (OA) is a common, debilitating chronic disease. Prolotherapy is an injection therapy for chronic musculoskeletal pain.

ABSTRACT: 
Background: 

Knee osteoarthritis (OA) is a common, debilitating chronic disease. Prolotherapy is an injection therapy for chronic musculoskeletal pain.

Recent 52-week randomized controlled and open label studies have reported improvement of knee OA-specific outcomes compared to baseline status, and blinded saline control injections and at-home exercise therapy (p<0.05). However, long term effects of prolotherapy for knee OA are unknown. We therefore assessed long-term effects of prolotherapy on knee pain, function and stiffness among adults with knee OA.

Methods: 

This is a post clinical-trial, open-label follow-up study. In the study, adults with mild-to-severe knee OA completing a 52-week prolotherapy study were enrolled.

Participants received 3-5 monthly interventions and were assessed using the validated Western Ontario McMaster University Osteoarthritis Index, (WOMAC, 0-100 points), at baseline, 12, 26, 52 weeks, and 2.5 years.

Results: 

65 participants (58±7.4 years old, 38 female) received 4.6±0.69 injection sessions in the initial 17-week treatment period.

They reported progressive improvement in WOMAC scores at all-time points in excess of minimal clinical important improvement benchmarks during the initial 52-week study period, from 13.8±17.4 points (23.6%) at 12 weeks, to 20.9±2.8 points, (p<0.05; 35.8% improvement) at 2.5±0.6 years (range 1.6-3.5 years) in the current follow-up analysis. Among assessed covariates, none were predictive of improvement in the WOMAC score.

Conclusion: 

Prolotherapy resulted in safe, significant, progressive improvement of knee pain, function and stiffness scores among most participants through a mean follow-up of 2.5 years and may be an appropriate therapy for patients with knee OA refractory to other conservative care.

Complement Ther Med. 2015 Jun;23(3):388-95

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