Literature DB >> 32393559

Efficacy of Intra-Articular Hypertonic Dextrose (Prolotherapy) for Knee Osteoarthritis: A Randomized Controlled Trial.

Regina Wing Shan Sit1, Ricky Wing Keung Wu2, David Rabago3, Kenneth Dean Reeves4, Dicken Cheong Chun Chan2, Benjamin Hon Kei Yip2, Vincent Chi Ho Chung2, Samuel Yeung Shan Wong2.   

Abstract

PURPOSE: To test the efficacy of intra-articular hypertonic dextrose prolotherapy (DPT) vs normal saline (NS) injection for knee osteoarthritis (KOA).
METHODS: A single-center, parallel-group, blinded, randomized controlled trial was conducted at a university primary care clinic in Hong Kong. Patients with KOA (n = 76) were randomly allocated (1:1) to DPT or NS groups for injections at weeks 0, 4, 8, and 16. The primary outcome was the Western Ontario McMaster University Osteoarthritis Index (WOMAC; 0-100 points) pain score. The secondary outcomes were the WOMAC composite, function and stiffness scores; objectively assessed physical function test results; visual analogue scale (VAS) for knee pain; and EuroQol-5D score. All outcomes were evaluated at baseline and at 16, 26, and 52 weeks using linear mixed model.
RESULTS: Randomization produced similar groups. The WOMAC pain score at 52 weeks showed a difference-in-difference estimate of -10.34 (95% CI, -19.20 to -1.49, P = 0.022) points. A similar favorable effect was shown on the difference-in-difference estimate on WOMAC function score of -9.55 (95% CI, -17.72 to -1.39, P = 0.022), WOMAC composite score of -9.65 (95% CI, -17.77 to -1.53, P = 0.020), VAS pain intensity score of -10.98 (95% CI, -21.36 to -0.61, P = 0.038), and EuroQol-5D VAS score of 8.64 (95% CI, 1.36 to 5.92, P = 0.020). No adverse events were reported.
CONCLUSION: Intra-articular dextrose prolotherapy injections reduced pain, improved function and quality of life in patients with KOA compared with blinded saline injections. The procedure is straightforward and safe; the adherence and satisfaction were high.
© 2020 Annals of Family Medicine, Inc.

Entities:  

Keywords:  intra-articular hypertonic dextrose; knee osteoarthritis; normal saline; prolotherapy; randomized clinical trial

Mesh:

Substances:

Year:  2020        PMID: 32393559      PMCID: PMC7214004          DOI: 10.1370/afm.2520

Source DB:  PubMed          Journal:  Ann Fam Med        ISSN: 1544-1709            Impact factor:   5.166


  48 in total

1.  Allergic reactions following the intravenous injection of corn sugar (dextrose).

Authors:  T G RANDOLPH; J P ROLLINS; C K WALTER
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2.  Therapeutic effects of prolotherapy with intra-articular dextrose injection in patients with moderate knee osteoarthritis: a single-arm study with 6 months follow up.

Authors:  Fariba Eslamian; Bahman Amouzandeh
Journal:  Ther Adv Musculoskelet Dis       Date:  2015-04       Impact factor: 5.346

3.  Obstacles to action in arthritis: a community case-control study.

Authors:  Ingrid Hutton; Greg Gamble; Grant McLean; Hugh Butcher; Peter Gow; Nicola Dalbeth
Journal:  Int J Rheum Dis       Date:  2009-07       Impact factor: 2.454

4.  Reliability and validity of the EuroQol in patients with osteoarthritis of the knee.

Authors:  M Fransen; J Edmonds
Journal:  Rheumatology (Oxford)       Date:  1999-09       Impact factor: 7.580

5.  Autologous interleukin-1 receptor antagonist improves function and symptoms in osteoarthritis when compared to placebo in a prospective randomized controlled trial.

Authors:  K G Auw Yang; N J H Raijmakers; E R A van Arkel; J J Caron; P C Rijk; W J Willems; J A C Zijl; A J Verbout; W J A Dhert; D B F Saris
Journal:  Osteoarthritis Cartilage       Date:  2007-09-06       Impact factor: 6.576

6.  The effect of disease site (knee, hip, hand, foot, lower back or neck) on employment reduction due to osteoarthritis.

Authors:  Eric C Sayre; Linda C Li; Jacek A Kopec; John M Esdaile; Sherry Bar; Jolanda Cibere
Journal:  PLoS One       Date:  2010-05-03       Impact factor: 3.240

7.  Effects of multiple injections of hypertonic dextrose in the rabbit carpal tunnel: a potential model of carpal tunnel syndrome development.

Authors:  Yuichi Yoshii; Chunfeng Zhao; James D Schmelzer; Phillip A Low; Kai-Nan An; Peter C Amadio
Journal:  Hand (N Y)       Date:  2014-03

8.  Probable anaphylactic reaction to corn-derived dextrose solution.

Authors:  S R Guharoy; M Barajas
Journal:  Vet Hum Toxicol       Date:  1991-12

9.  Validation of Chinese Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) in patients scheduled for total knee replacement.

Authors:  Feng Xie; Shu-Chuen Li; Ron Goeree; Jean-Eric Tarride; Daria O'Reilly; Ngai-Nung Lo; Seng-Jin Yeo; Kuang-Ying Yang; Julian Thumboo
Journal:  Qual Life Res       Date:  2008-05       Impact factor: 4.147

Review 10.  Hypertonic dextrose injections (prolotherapy) in the treatment of symptomatic knee osteoarthritis: A systematic review and meta-analysis.

Authors:  Regina Ws Sit; Vincent Ch Chung; Kenneth D Reeves; David Rabago; Keith Kw Chan; Dicken Cc Chan; Xinyin Wu; Robin St Ho; Samuel Ys Wong
Journal:  Sci Rep       Date:  2016-05-05       Impact factor: 4.379

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  8 in total

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2.  Combine Approach of Proximal Fibula Osteotomy (PFO) Followed by Intra-Articular Dextrose Prolotherapy in Severe Medial Knee Osteoarthritis.

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3.  A comprehensive review of intraarticular knee injection therapy, geniculate injections, and peripheral nerve stimulation for knee pain in clinical practice.

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Journal:  Orthop Rev (Pavia)       Date:  2022-10-13

Review 4.  Motor-Sparing Neural Ablation with Modified Techniques for Knee Pain: Case Series on Knee Osteoarthritis and Updated Review of the Underlying Anatomy and Available Techniques.

Authors:  Tony Kwun-Tung Ng; King Hei Stanley Lam; Abdallah El-Sayed Allam
Journal:  Biomed Res Int       Date:  2022-05-31       Impact factor: 3.246

5.  Dextrose Effects on Platelet Count and Volume: Implications for Regenerative Medicine.

Authors:  Theodore E Harrison; Jannice Bowler; K Dean Reeves; Todd N Levins; An-Lin Cheng
Journal:  Cureus       Date:  2022-05-17

Review 6.  Dextrose prolotherapy in knee osteoarthritis: A systematic review and meta-analysis.

Authors:  Tze Chao Wee; Edmund Jin Rui Neo; Yeow Leng Tan
Journal:  J Clin Orthop Trauma       Date:  2021-05-20

7.  Changes in levels of cartilage oligomeric proteinase and urinary C-terminal telopeptide of type II collagen in subjects with knee osteoarthritis after dextrose prolotherapy: A randomized controlled trial.

Authors:  Yose Waluyo; Agussalim Bukhari; Endy Adnan; Ratna Darjanti Haryadi; Irfan Idris; Firdaus Hamid; Andry Usman; Muhammad Phetrus Johan; Andi Alfian Zainuddin
Journal:  J Rehabil Med       Date:  2021-05-24       Impact factor: 2.912

8.  Efficacy of hypertonic dextrose injection (prolotherapy) in temporomandibular joint dysfunction: a systematic review and meta-analysis.

Authors:  Regina Wing-Shan Sit; Kenneth Dean Reeves; Claire Chenwen Zhong; Charlene Hoi Lam Wong; Bo Wang; Vincent Chi-Ho Chung; Samuel Yeung-Shan Wong; David Rabago
Journal:  Sci Rep       Date:  2021-07-19       Impact factor: 4.379

  8 in total

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