Hypertonic dextrose versus corticosteroid local injection for the treatment of osteoarthritis in the first carpometacarpal joint: a double-blind randomized clinical trial

Jahangiri, Azadeh; Moghaddam, Farid Rezaiee; Najafi, Sharif

doi:10.1007/s00776-014-0587-2

Cited by 51 publications

(81 citation statements)

References 22 publications

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“…Prolotherapy had an insignificant advantage over corticosteroid injection in knee OA and lateral epicondylosis . Some randomized controlled trials found a better long‐term effect of prolotherapy over steroid injection in knee OA and sacroiliac joint pain . Our univariate analysis indicated that a prior intervention was not associated with substantial pain reduction, which may imply that the effectiveness of US‐guided prolotherapy would not be affected by prior treatment of refractory acromial enthesopathy and acromioclavicular joint arthropathy.…”

Section: Discussionsupporting

confidence: 92%

Ultrasound‐Guided Prolotherapy for Acromial Enthesopathy and Acromioclavicular Joint Arthropathy: A Single‐Arm Prospective Study

Hsieh

Chiou

Wang

et al. 2018

J of Ultrasound Medicine

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Section: Discussionsupporting

confidence: 92%

Ultrasound‐Guided Prolotherapy for Acromial Enthesopathy and Acromioclavicular Joint Arthropathy: A Single‐Arm Prospective Study

Hsieh

Chiou

Wang

et al. 2018

J of Ultrasound Medicine

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“…There are 2 studies with level I evidence supporting the use of prolotherapy in OA of the fingers. Reeves and Hassanein [25] and Jahangiri et al [26] reported significantly improved pain in prolotherapy‐treated patients; Reeves and Hassanein [25] also noted significantly improved finger flexion range of motion and decreased joint space narrowing in the experimental group.…”

Section: Common Regenerative Methodsmentioning

confidence: 85%

Regenerative Sports Medicine: Past, Present, and Future (Adapted From the PASSOR Legacy Award Presentation; AAPMR; October 2016)

Borg‐Stein

Osoria

Hayano

2018

PM&R

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Regenerative medicine has shown dramatic expanse and evolution in the past decade. Within that milieu, physiatrists are taking an active role in research, clinical care delivery, and education. The purpose of this review is to provide a balance among evidence, theory, experience, clinical trends, and the foreseeable future. We focus on the literature that reports the research with the best methodology in each practice area, recognizing that the level of evidence varies substantially among different treatment modalities and conditions. The following elements are included: an overview of the evolution of currently available regenerative techniques, evidence base for each available modality (prolotherapy, platelet rich plasma, bone marrow aspirate concentrate and stem cells, adipose-derived stem cells, and amniotic tissue products), general principles in the application of these treatments, and discussion and a vision of what lies ahead. We expect that practitioners will use this review to facilitate clinical decision making and to provide a core knowledge base to assist when counseling patients. LEVEL OF EVIDENCE: IV.

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“…We excluded one single-arm trial, due to lack of quantitative pain evaluation in patients with patellar chondro-arthropathy,18 one RCT comparing single injection of dextrose with erythropoietin,19 one RCT targeting nonspecific chronic low back pain without definite radiologic evidence of lumbar spine osteoarthritis,20 and two observational studies analyzing data from a published RCT exploring knee osteoarthritis 21,22. The final meta-analysis included one single-arm follow-up trial23 and five RCTs,7,8,24–26 four of which probed knee osteoarthri tis7,23,24,26 and two of which examined hand osteoarthritis 8,25. Regarding the comparative injection regimens in the five RCTs, one used two serial saline injections followed by one shot of corticosteroids,25 three used sequential administrations of local anesthetics,7,8,24 and one used a crossover design by implementing the dextrose injection at different time points 26…”

Section: Resultsmentioning

confidence: 99%

“…The final meta-analysis included one single-arm follow-up trial23 and five RCTs,7,8,24–26 four of which probed knee osteoarthri tis7,23,24,26 and two of which examined hand osteoarthritis 8,25. Regarding the comparative injection regimens in the five RCTs, one used two serial saline injections followed by one shot of corticosteroids,25 three used sequential administrations of local anesthetics,7,8,24 and one used a crossover design by implementing the dextrose injection at different time points 26…”

Section: Resultsmentioning

confidence: 99%

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Comparative effectiveness of dextrose prolotherapy versus control injections and exercise in the management of osteoarthritis pain: a systematic review and meta-analysis

Hung

Hsiao

Chang

et al. 2016

JPR

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BackgroundIncreasing evidence has supported the use of dextrose prolotherapy for patients with osteoarthritis. However, the real benefits may be affected by differences in injection protocols, comparative regimens, and evaluation scales.MethodsPubMed and Scopus were searched from the earliest record until February 2016. One single-arm study and five randomized controlled trials were included, comprising 326 participants. We estimated the effect sizes of pain reduction before and after serial dextrose injections and compared the values between dextrose prolotherapy, comparative regimens, and exercise 6 months after the initial injection.ResultsRegarding the treatment arm using dextrose prolotherapy, the effect sizes compared with baseline were 0.65 (95% confidence interval [CI], 0.14–1.17), 0.84 (95% CI, 0.40–1.27), 0.85 (95% CI, 0.60–1.10), and 0.87 (95% CI, 0.53–1.21) after the first, second, third, and fourth or more injections, respectively. The overall effect of dextrose was better than control injections (effect size, 0.36; 95% CI, 0.10–0.63). Dextrose prolotherapy had a superior effect compared with local anesthesia (effect size, 0.38; 95% CI, 0.07–0.70) and exercise (effect size, 0.71; 95% CI, 0.30–1.11). There was an insignificant advantage of dextrose over corticosteroids (effect size, 0.31; 95% CI, –0.18 to 0.80) which was only estimated from one study.ConclusionDextrose injections decreased pain in osteoarthritis patients but did not exhibit a positive dose–response relationship following serial injections. Dextrose prolotherapy was found to provide a better therapeutic effect than exercise, local anesthetics, and probably corticosteroids when patients were retested 6 months following the initial injection.

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Hypertonic dextrose versus corticosteroid local injection for the treatment of osteoarthritis in the first carpometacarpal joint: a double-blind randomized clinical trial

Cited by 51 publications

References 22 publications

Ultrasound‐Guided Prolotherapy for Acromial Enthesopathy and Acromioclavicular Joint Arthropathy: A Single‐Arm Prospective Study

Ultrasound‐Guided Prolotherapy for Acromial Enthesopathy and Acromioclavicular Joint Arthropathy: A Single‐Arm Prospective Study

Regenerative Sports Medicine: Past, Present, and Future (Adapted From the PASSOR Legacy Award Presentation; AAPMR; October 2016)

Comparative effectiveness of dextrose prolotherapy versus control injections and exercise in the management of osteoarthritis pain: a systematic review and meta-analysis

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