The effectiveness of prolotherapy in treating knee osteoarthritis in adults: a systematic review

Hassan, Fadi; Trebinjac, Suad; Murrell, William; Maffulli, Nicola

doi:10.1093/bmb/ldx006

Cited by 44 publications

(31 citation statements)

References 28 publications

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“…Often included in the regenerative therapies, prolotherapy is a relatively uncommon treatment for treating K-OA with very little scientific evidence. However, as a relatively simple and inexpensive treatment modality with a high safety profile, prolotherapy is something that could easily be performed in the primary care setting and is thus worth our consideration [67][68][69][70]. A hypertonic irritating solution is used to treat the affected knee and can be injected both periand intra-articular.…”

Section: Prolotherapymentioning

confidence: 99%

“…A small study published in 2017 showed no significant changes in WOMAC and VAS scores between patients treated with either intra-or periarticular prolotherapy [67]. ere are some variabilities in the method of peri-articular administration of the dextrose, but the two key techniques are either Lyftogt's technique or Hackett's technique [69]. In Lyftogt's technique, dextrose is injected into subcutaneous tissues.…”

Section: Prolotherapymentioning

confidence: 99%

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Procedural Treatments for Knee Osteoarthritis: A Review of Current Injectable Therapies

Billesberger¹,

Fisher

Qadri

et al. 2020

Pain Research and Management

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Knee osteoarthritis is a common painful degenerative condition affecting the aging Canadian population. In addition to pain and disability, osteoarthritis is associated with depression, comorbid conditions such as diabetes, and increased caregiver burden. It is predicted to cost the Canadian healthcare system $7.6 billion dollars by 2031. Despite its high cost and prevalence, controversy persists in the medical community regarding optimal therapies to treat knee osteoarthritis. A variety of medications like nonsteroidal anti-inflammatories and opioids can cause severe side effects with limited benefits. Total knee arthroplasty, although a definitive management, comes with risk such as postoperative infections, revisions, and chronic pain. Newer injectable therapies are gaining attention as alternatives to medications because of a safer side effect profile and are much less invasive than a joint replacement. Platelet-rich plasma is beginning to replace the more common injectable therapies of intra-articular corticosteroids and hyaluronic acid, but larger trials are needed to confirm this effect. Small studies have examined prolotherapy and stem cell therapy and demonstrate some benefits. Trials involving genicular nerve block procedures have been successful. As treatments evolve, injectable therapies may offer a safe and effective pathway for patients suffering from knee osteoarthritis.

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Section: Prolotherapymentioning

confidence: 99%

Section: Prolotherapymentioning

confidence: 99%

Procedural Treatments for Knee Osteoarthritis: A Review of Current Injectable Therapies

Billesberger¹,

Fisher

Qadri

et al. 2020

Pain Research and Management

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show abstract

“…Nevertheless, the clinical outcomes including pain, joint stiffness and physical function were also improved. This nding indicated that the hypertonic dextrose intra-articular injections for OA knee patients have a clinically effect lasting from weeks to months post treatment [20,21].…”

Section: Discussionmentioning

confidence: 89%

“…Dextrose prolotherapy is an alternative to surgery for knee osteoarthritis patients. The potential mechanism of dextrose prolotherapy relevant pain-intensity reduction is associated with the hyperpolarization of nociceptive pain bers by opening the potassium channels [21]. Prolotherapy simulates the normal tissues' healing and repair response, which includes the three stages of in ammation, proliferation, and tissue remodeling [23].…”

Section: Discussionmentioning

confidence: 99%

Identification of early response to hypertonic dextrose prolotherapy markers in knee osteoarthritis patients by an inflammation-related cytokine array

Kuo¹,

Pan²,

Wang³

et al. 2020

Preprint

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BACKGROUND/AIMOsteoarthritis (OA) is one of the most common forms of arthritis, and hypertonic dextrose prolotherapy has long been used clinically to treat knee OA. The aim of this study was to investigate the inflammation-related protein-expression profile characterizing the efficacy of the hypertonic dextrose prolotherapy in knee OA as prognostic markers.METHODSOA patients over the age of 65 were recruited for Western Ontario McMaster University Osteoarthritis (WOMAC) index, knee X ray evaluation and knee joint synovial fluid analysis before and after hypertonic dextrose prolotherapy. The expressions of inflammation-related factors were measured using a novel cytokine antibody array methodology. The cytokine levels were quantified by quantitative protein expression and analyzed by ELISA using the patients’ knee-joint synovial fluid. The WOMAC Index and minimum joint space width prior to receiving the intra-articular injection and at 2-week intervals were compared.RESULTS12 patients who received OA intervention were enrolled and finally a clinical evaluation of 12 knee joints and knee synovial fluid samples were analyzed. In this study, after receiving hypertonic dextrose prolotherapy, the OA patients clearly demonstrated a significant improvement in WOMAC index and increasing tendency in the medial minimum joint space width after intervention. Meanwhile, we observed a significantly associated tendency between the high-glucose treatment of knee OA and the upregulation of MMP2, TIMP-1, EGF, CXCL9 and IL-22. These findings provide knee OA patients receiving hypertonic dextrose prolotherapy, which accompanying with the improvement of knee pain, stiffness, and function and increasing tendency in the medial minimum joint space width.

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“…8,9 Studies have shown that prolotherapy is efficacious in the management of knee osteoarthritis and tendinopathy. 10,11 We agree that the evidence to support its use in the context of RCLs is less robust Hong Kong Med J 2018;24:538-9 DOI: 10.12809/hkmj187528…”

Section: Dextrose Prolotherapy For Rotator Cuff Lesions: the Challengmentioning

confidence: 94%

Dextrose prolotherapy for rotator cuff lesions: the challenges and the future

Sit

Rabago

2018

Hong Kong Med J

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The effectiveness of prolotherapy in treating knee osteoarthritis in adults: a systematic review

Abstract: Future research should focus on larger sample size, standardization of treatment protocol and basic science evidence.

Cited by 44 publications

References 28 publications

Procedural Treatments for Knee Osteoarthritis: A Review of Current Injectable Therapies

Procedural Treatments for Knee Osteoarthritis: A Review of Current Injectable Therapies

Identification of early response to hypertonic dextrose prolotherapy markers in knee osteoarthritis patients by an inflammation-related cytokine array

Dextrose prolotherapy for rotator cuff lesions: the challenges and the future

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