| Farpour and Fereydooni [@113531]
(2017) |
RCT/2-arm |
OKS
WOMAC:
- pain
- stiffness
- function
- total
VAS |
52 adults between the ages of 38-70 with primary KOA for at least 3 months.
Randomly allocated into groups of 25 (2 participants dropped due to personal reasons) to
receive either intra- articular (6 ml of 25% dextrose) or periarticular (6 ml of 25% dextrose) injections of dextrose prolotherapy.
Two injections were given in a two-week interval. |
VAS, OKS, and WOMAC scores after dextrose prolotherapy improved from 7.32±1.46 (VAS), 23.52±7.77 (OKS), and 46.52±14.19 (WOMAC) at baseline to 5.00±2.27, 28.36±9.62, and 36.44±16.2 at 8 weeks in the periarticular injection group (p<0.001).
VAS, OKS, and WOMAC scores in the intra-articular group also improved from 7.80±1.70 (VAS), 24.72±7.13 (OKS), and 45.68±11.18 (WOMAC) at baseline to 5.90±2.69, 27.76±8.67, and 39.36±14.88 at eight weeks (p<0.001).
No significant difference in any outcome measurement between the two groups. |
Dextrose prolotherapy, either by peri- or intra-articular injection can be used in the management of KOA. Periarticular injection seems to be more easily performed by healthcare professionals, and less painful than other management options. |
| Rahimzadeh et al. [@113536]
(2018) |
RCT/ 2-arm |
WOMAC:
- Composite
- functional limitation
- pain level
- stiffness |
42 patients between the ages of 40-70 with stage 1 or 2 KOA.
Randomly allocated into groups of 21 to receive intra-articular injections of either 7mL of platelet-rich plasma or 7mL 25% dextrose. Injections given at 0 months and 1 month. |
In both groups the overall WOMAC score at 6 months was significantly decreased compared to baseline.
WOMAC decreased in the PRP group from 67.9±7.3 at baseline to 31.4±10.2 at 6 months (P<0.001).
WOMAC decreased in the DPT group from 67.1±7.9 at baseline to 38.7±6.6 at 6 months (P<0.001). |
Both PRP injections and DPT can be used to reduce pain and improve quality of life in patients with mild KOA. |
| Pishgahi et al.
[@113538]
(2020) |
RCT/3 arms |
WOMAC
VAS |
92 patients between the ages of 40-75 with KOA.
Randomly allocated into groups of 30 (DPT), 30 (PRP), and 32 (ACS) to receive 50 % dextrose prolotherapy, platelet-rich plasma, or autologous conditions serum (ACS).
Dextrose injections were given once a week over a three-week period.
PRP and ACS injections were given twice every seven days. |
VAS scores in the ACS group showed significant improvement at 6 months compared to the dextrose and PRP groups (P<0.001).
WOMAC scores in the dextrose group at one month and 6 months were significantly less improved than those measured in the PRP and ACS groups (p<0.001).
WOMAC scores in the ACS group at one month and 6 months were significantly improved compared to the dextrose group (p<0.001).
No significant difference in the WOMAC scores of the ACS and PRP groups at one month and 6 months (p=0.999) |
ACS therapy could potentially be used as an alternative to PRP therapy or DPT to effectively reduce pain and improve knee function long term in patients with KOA. |
| Rezasoltani et al. [@113498]
(2020) |
RCT/4 arms |
Primary:
VAS pain
Secondary:
KOOS |
120 patients 50 years of age and older with KOA.
Randomly assigned to one of four groups: Physical therapy group- superficial heat, transcutaneous electrical nerve stimulation, and pulsed ultrasound
Botulinum neurotoxin group-
one intra-articular injection of botulinum neurotoxin type A
Hyaluronic acid group- injections of hyaluronic acid given 3 times weekly
Dextrose prolotherapy group- injections of 20% dextrose given 3 times weekly |
Effects on VAS and KOOS score were significantly less in the hyaluronic acid group compared to all other groups (P<0.05).
VAS scores were significantly improved in the botulinum neurotoxin group compared to the physical therapy group (P=0.015).
No statistically significant reduction in KOOS scores of the botulinum neurotoxin and dextrose groups compared to physical therapy. |
Botulinum toxin and dextrose prolotherapy combined with exercise can both be used to effectively control pain over several months in patients with KOA. While physical therapy alone was not as effective at reducing pain compared to botulinum toxin and dextrose, its effects on KOOS scores were comparable suggesting a benefit for patients with KOA. |
| Sit et al. [@113529]
(2020) |
RCT/ 2 arm |
Primary:
WOMAC pain score at 52 weeks
Secondary:
WOMAC
- composite
- function
- stiffness
VAS knee pain
Physical function
EuroQol-5D score |
76 patients between the ages of 45-75 years old with KOA from general outpatient clinics in Hong Kong.
Randomly allocated into 2 groups of 36 and received either DPT (5 ml of 25% dextrose) or NS (5 ml of normal saline) injections at weeks 0, 4, 8, and 16. |
Difference-in-difference estimates revealed favorable outcomes on:
The WOMAC pain score at 52 weeks:
-10.34 (-19.20 to -1.49, P = 0.022) points.
WOMAC function score: -9.55 (-17.72 to -1.39, P = 0.022)
WOMAC composite score: -9.65 (-17.77 to -1.53, P = 0.020)
VAS pain intensity score: -10.98 (-21.36 to -0.61, P = 0.038)
EuroQol-5D VAS score of 8.64 (1.36 to 5.92, P = 0.020).
No statistical difference found in physical function tests or medication use (P= 0.350) |
Compared to normal saline, dextrose prolotherapy improved measurements of pain, function, and quality of life in patients with KOA |