Efficacy of Prolotherapy for Osteoarthritis: A Systematic Review (original) (raw)
Related papers
Therapeutic advances in musculoskeletal disease, 2015
Prolotherapy is an injection-based complementary treatment, which has shown promising results in the treatment of different musculoskeletal disorders. The aim of this study was to determine the therapeutic efficacy of dextrose prolotherapy on pain, range of motion, and function in patients with knee osteoarthritis (OA). In this single-arm prospective study, participants with symptomatic moderate knee osteoarthritis underwent prolotherapy with intra-articular injection of 20% dextrose water at baseline, and at 4 weeks and 8 weeks later. Patients were followed for 24 weeks. Pain severity at rest and activity, according to the visual analog scale (VAS), articular range of motion (ROM), and Western Ontario and McMaster Universities arthritis index (WOMAC) scores were measured at baseline, 4, 8, and 24 weeks later. A total of 24 female patients (average age: 58.37 ± 11.8 years old) received 3-monthly injection therapies. Before the treatment, the mean articular range of motion was 105.41...
Jurnal Kedokteran dan Kesehatan Indonesia
Background: Osteoarthritis currently remains a significant health problem due to its high prevalence and morbidity rate. Radiological examination is still used as a gold standard to determine the severity of knee osteoarthritis by using Kellgren-Lawrence grading. Dextrose prolotherapy has been known to be effective in treating pain in knee osteoarthritis, but none has compared the efficacy between mild and moderate-severe knee osteoarthritis. Objective: This study aims to compare the effectiveness of prolotherapy based on its radiological and symptomatic severity in knee osteoarthritis.Methods: In this pre-post study, the participants who underwent dextrose prolotherapy injection (25% intra-articular and 15% periarticular) for three sessions with four weeks intervals were grouped into mild (grade 1-2) and severe (grade 3-4) groups. Participants’ functional status was measured with Western Ontario and McMaster Universities’ arthritis index scores at baseline and week 12.Results: A to...
The Journal of Alternative and Complementary Medicine, 2012
Objective: The objective of this study was to determine whether prolotherapy, an injection-based complementary treatment for chronic musculoskeletal conditions, improves pain, stiffness, and function in adults with symptomatic knee osteoarthritis (KOA) compared to baseline status. Design: This was a prospective, uncontrolled study with 1-year follow-up. Setting: The study was conducted in an outpatient setting. Participants: Adults with at least 3 months of symptomatic KOA, recruited from clinical and community settings, participated in the study. Interventions: Participants received extra-articular injections of 15% dextrose and intra-articular prolotherapy injections of 25% dextrose at 1, 5, and 9 weeks, with as-needed treatments at weeks 13 and 17. Outcome measures: Primary outcome measure was the validated Western Ontario McMaster University Osteoarthritis Index (WOMAC). Secondary outcome measure was the validated Knee Pain Scale (KPS). Tertiary outcome measure was procedure-related pain severity and participant satisfaction. Results: Thirty-six (36) participants (60 -8.7 years old, 21 female) with moderate-to-severe KOA received an average of 4.3 -0.7 prolotherapy injection sessions over a 17-week treatment period and reported progressively improved scores during the 52-week study on WOMAC and KPS measures. Participants reported overall WOMAC score improvement 4 weeks after the first injection session (7.6 -2.4 points, 17.2%), and continued to improve through the 52-week follow-up (15.9 -2.5 points, p < 0.001, 36.1%). KPS scores improved in both injected ( p < 0.001) and uninjected knees ( p < 0.05). Prescribed low-dose opioid analgesia effectively treated procedurerelated pain. Satisfaction was high and there were no adverse events. Female gender, age 46-65 years old, and body-mass index of 25 kg/m 2 or less were associated with greater improvement on the WOMAC instrument. Conclusions: In adults with moderate to severe KOA, dextrose prolotherapy may result in safe, significant, sustained improvement of knee pain, function, and stiffness scores. Randomized multidisciplinary effectiveness trials including evaluation of potential disease modification are warranted to further assess the effects of prolotherapy for KOA.
The effectiveness of prolotherapy in treating knee osteoarthritis in adults: a systematic review
British Medical Bulletin
Introduction: Osteoarthritis (OA) often leads to symptoms such as pain, stiffness and decreased function. OA is treated with a wide range of modalities, both conservatively and surgically. Prolotherapy has been used to treat various musculoskeletal problems and has shown some promise. Sources of data: Searches of the electronic databases, PubMed, ISI web of science, PEDro and SPORTDiscus, were conducted for all Level 1-4 studies published from inception through to December 2016. Areas of agreement: Ten studies were evaluated and results show significant improvement in scores for pain, function and range of motion, both in the short term and long term. Patient satisfaction was also high in these patients (82%). Areas of controversy: Meta-analysis was not possible due to heterogeneity of outcome measures and populations. Growing points: Moderate evidence suggests that prolotherapy is safe and can help achieve significant symptomatic control in individuals with OA.
Egyptian Rheumatology and Rehabilitation, 2021
Background Osteoarthritis (OA) is a degenerative disease which presents with joint pain and stiffness and reduced mobility. Knee OA is the commonest cause of disability in adults. Dextrose prolotherapy is a new option used to treat mild-to-moderate knee OA. Neural prolotherapy (NPT) is multiple small injections under the skin targeting painful areas with natural substances. The aim of work was to evaluate and compare neural prolotherapy versus intra-articular dextrose prolotherapy effect on relieving pain and improving disability of knee OA. Results VAS and WOMAC scores improved significantly immediately and at 3 and at 6 months, respectively, in group I compared with group II (P < 0.001). The decrease in VAS scores and all the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores in group I along the follow-up period in comparison with the baseline scores was statistically significant (P < 0.001). In group II, only WOMAC pain and stiffness scores impro...
The Journal of Alternative and Complementary Medicine, 2014
Objectives: This study determined whether injection with hypertonic dextrose and morrhuate sodium (prolotherapy) using a pragmatic, clinically determined injection schedule for knee osteoarthritis (KOA) results in improved knee pain, function, and stiffness compared to baseline status. Design: This was a prospective three-arm uncontrolled study with 1-year follow-up. Setting: The setting was outpatient. Participants: The participants were 38 adults who had at least 3 months of symptomatic KOA and who were in the control groups of a prior prolotherapy randomized controlled trial (RCT) (Prior-Control), were ineligible for the RCT (Prior-Ineligible), or were eligible but declined the RCT (Prior-Declined). Intervention: The injection sessions at occurred at 1, 5, and 9 weeks with as-needed treatment at weeks 13 and 17. Extra-articular injections of 15% dextrose and 5% morrhuate sodium were done at peri-articular tendon and ligament insertions. A single intra-articular injection of 6 mL 25% dextrose was performed through an inferomedial approach. Outcome measures: The primary outcome measure was the validated Western Ontario McMaster University Osteoarthritis Index (WOMAC). The secondary outcome measure was the Knee Pain Scale and postprocedure opioid medication use and participant satisfaction. Results: The Prior-Declined group reported the most severe baseline WOMAC score (p = 0.02). Compared to baseline status, participants in the Prior-Control group reported a score change of 12.4-3.5 points (19.5%, p = 0.002). Prior-Decline and Prior-Ineligible groups improved by 19.4-7.0 (42.9%, p = 0.05) and 17.8-3.9 (28.4%, p = 0.008) points, respectively; 55.6% of Prior-Control, 75% of Prior-Decline, and 50% of Prior-Ineligible participants reported score improvement in excess of the 12-point minimal clinical important difference on the WOMAC measure. Postprocedure opioid medication resulted in rapid diminution of prolotherapy injection pain. Satisfaction was high and there were no adverse events. Conclusions: Prolotherapy using dextrose and morrhuate sodium injections for participants with mild-to-severe KOA resulted in safe, significant, sustained improvement of WOMAC-based knee pain, function, and stiffness scores compared to baseline status.
Electronic Physician
Background: Osteoarthritis is a common degenerative disease. Prolotherapy is an alternative therapy used in multiple musculoskeletal disorders. Objective: To compare the effectiveness of intra-articular dextrose injection versus peri-articular prolotherapy in patients with knee osteoarthritis (KOA). Methods: Fifty-two adults with painful primary knee osteoarthritis for at least three months were randomized to intra-and peri-articular injection groups. Prolotherapy was done twice with two week intervals. The outcome measures included the Oxford Knee Scale (OKS), Western Ontario McMaster University Osteoarthritis Index (WOMAC), and Visual Analogue Scale (VAS), which were obtained from patients before the first injection at the base line and after the second injection at the fourth and eighth weeks. Results: There were no statistically significant differences between demographic characteristics; before the injection, pain intensity, OKS, and WOMAC scores were approximately equal between the two groups. After dextrose prolotherapy, VAS, OKS, and WOMAC scores improved from baseline through the fourth and eighth weeks in both groups without any superiority between the two methods of injections (p<0.001). Conclusion: Dextrose prolotherapy either intra-or peri-articular injection resulted in significant improvement, so it could be an inexpensive and effective management of knee osteoarthritis. Trial registration: The study protocol was registered as a clinical trial under registration ID of IRCT2016091229795N1 at the Iranian Registry of Clinical Trials (http://www.irct.ir).
International journal of traditional and complementary medicine research, 2021
Objective: Determination of the effectiveness of periarticular 5% dextrose prolotherapy in the treatment of knee pain due to osteoarthritis. Material and Methods: The clinical results of prolotherapy with 5% periarticular dextrose in adult female and male patients with knee pain and complaints related to osteoarthritis were evaluated retrospectively. During the examination, we identified the sensitive ligaments in the knee and injected 1 cc of 5% dextrose with a 0.6 * 60 mm sterican needle. In routine practice, stretching exercises are recommended to patients after prolotherapy and for analgesia, a combined analgesic containing paracetemol 500mg + codeine phosphate 10mg + caffeine 30mg is given for the first 3 days. In addition to the initial application, prolotherapy is performed 3 times with an interval of 20 days, and when the Visual Analogue Scale (VAS) score decreases by 80% or more after the first or second injection, prolotherapy is terminated. Results: 30 patients aged between 36-70 years were included in the study. Patients' mean age was 52,9±9,0 years. Nineteen patients received 3 sessions and 11 patients received 2 sessions of prolotherapy. A significant decrease was achieved in VAS scores of all patients except one patient. The VAS score was 2.9 at the end of the third session meanwhile the initial VAS average was 8.4. None of the patients had any side effects that would terminate the treatment. Conclusion: The data obtained in the study show that prolotherapy with periarticular 5% dextrose is effective in the treatment of knee pain and complaints related to osteoarthritis. However, more comprehensive studies will be guiding the clarification of its place in the osteoarthritis' treatment.
Anesthesiology and Pain Medicine, 2015
Background: Knee osteoarthritis (KOA) is a common disabling disease. Limited studies have demonstrated that prolotherapy with dextrose or with prolozone can be helpful in the treatment of patients with KOA. Objectives: In the current study, we compared the results between these two treatment methods. Patients and Methods: In the current randomized clinical trial, 80 patients with mild to moderate KOA were randomly assigned equally into two groups (ozone group and dextrose group). In each group, injections were repeated three times with 10-day intervals. Before the treatment and 3 months after the injections, the pain intensity was measured by using a visual analogue scale and the Western Ontario and McMaster university arthritis index scores. Finally, the results were compared between the two groups. Results: In the two groups, the pain intensity and WOMAC scores significantly decreased and increased, respectively (P < 0.001). However, there was no significant difference between the two groups. Conclusions: Prolotherapy with dextrose and with prolozone result in the same pain relief or functional improvement in patients with mild to moderate KOA.
JPHV (Journal of Pain, Vertigo and Headache), 2020
Knee osteoarthritis (OA) is one of the most common cartilage degenerative disorders that is a major problem because it causes chronic pain and disability. Therefore the method of treatment and prevention of old age is a big challenge. The results of Dextrose Prolotherapy compared to Triamcinolone therapy research are still varied. Objective: to compare the effectiveness of Dextrose Prolotherapy and Triamcinolone Acetonide (TA) in the treatment of moderate knee knee OA.True experimental single blind study, at the Neurology Polyclinic Dr. Saiful Anwar General Hospital Malang for 6 months (July-December 2019). Group I; Dextrose Prolotherapy (15%) intraarticularly injected 3 times every 4 weeks and group II; TA one-time intraarticular injection.