Prolotherapy and Osteoarthritis of the Knee
This study assessed 36 adults with moderate-severe chronic knee osteoarthritis(KOA). Pain, stiffness, and functionality were assessed in symptomatic adults over one year using WOMAC (range 0-96), and two other measures.
As a control, participants were randomly assigned exercise therapy for 32 weeks with prolotherapy injections during the first (weeks 0, 4, 8, 12) or latter (weeks 20, 24, 28, 32) half. The prolotherapy solution consisted of lidocaine anaesthetic, and 15% dextrose extra-articular, and 20% intra-articular.
After 16 weeks, participant follow up showed those assigned to the prolotherapy group had a significant reduction in symptoms (-21.8+/-12.5, P<0.001) based on WOMAC which lasted through the latter 16 weeks of the study, and were not significantly improved by exercise therapy alone (-1.2+/-10.7, P=0.65). Those assigned to the exercise therapy only group after the first 16 weeks did not significantly improve (-6.1 +/-13.9, P=0.11), however a significant change was apparent during the latter 16 weeks when prolotherapy was introduced (-9.3+/-11.4, P=0.006). After 36 weeks, both groups improved by 47.3% and 36.2% and the amount attributable to prolotherapy alone corresponds to a 29.5% decrease in WOMAC scores.
Prolotherapy is an important part of a treatment plan for chronic KOA that has lasting effects, and appears to be most effective when coupled with exercise therapy early in the course of treatment.
Reference: Dumais R, Benoit C, Dumais A, Babin L, Bordage R, de Arcos C, Allard J, Bélanger M. Effect of Regenerative Injection Therapy on Function and Pain in Patients with Knee Osteoarthritis: A Randomized Crossover Study. Pain Medicine. Aug 2012. Vol. 13(8); 990-9.