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Research ArticleOriginal Research

Dextrose Prolotherapy for Knee Osteoarthritis: A Randomized Controlled Trial

David Rabago, Jeffrey J. Patterson, Marlon Mundt, Richard Kijowski, Jessica Grettie, Neil A. Segal and Aleksandra Zgierska
The Annals of Family Medicine May 2013, 11 (3) 229-237; DOI: https://doi.org/10.1370/afm.1504
David Rabago
1Department of Family Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
MD
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  • For correspondence: david.rabago@fammed.wisc.edu
Jeffrey J. Patterson
1Department of Family Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
DO
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Marlon Mundt
1Department of Family Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
PhD
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Richard Kijowski
2Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
MD
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Jessica Grettie
1Department of Family Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
BS
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Neil A. Segal
3Departments of Orthopaedics & Rehabilitation, Epidemiology, and Radiology, The University of Iowa, Iowa City, Iowa
MD, MS
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Aleksandra Zgierska
1Department of Family Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
MD, PhD
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This article has a correction. Please see:

  • CORRECTION - September 01, 2013

Abstract

PURPOSE Knee osteoarthritis is a common, debilitating chronic disease. Prolotherapy is an injection therapy for chronic musculoskeletal pain. We conducted a 3-arm, blinded (injector, assessor, injection group participants), randomized controlled trial to assess the efficacy of prolotherapy for knee osteoarthritis.

METHODS Ninety adults with at least 3 months of painful knee osteoarthritis were randomized to blinded injection (dextrose prolotherapy or saline) or at-home exercise. Extra- and intra-articular injections were done at 1, 5, and 9 weeks with as-needed additional treatments at weeks 13 and 17. Exercise participants received an exercise manual and in-person instruction. Outcome measures included a composite score on the Western Ontario McMaster University Osteoarthritis Index (WOMAC; 100 points); knee pain scale (KPS; individual knee), post-procedure opioid medication use, and participant satisfaction. Intention-to-treat analysis using analysis of variance was used.

RESULTS No baseline differences existed between groups. All groups reported improved composite WOMAC scores compared with baseline status (P <.01) at 52 weeks. Adjusted for sex, age, and body mass index, WOMAC scores for patients receiving dextrose prolotherapy improved more (P <.05) at 52 weeks than did scores for patients receiving saline and exercise (score change: 15.3 ± 3.5 vs 7.6 ± 3.4, and 8.2 ± 3.3 points, respectively) and exceeded the WOMAC-based minimal clinically important difference. Individual knee pain scores also improved more in the prolotherapy group (P = .05). Use of prescribed postprocedure opioid medication resulted in rapid diminution of injection-related pain. Satisfaction with prolotherapy was high. There were no adverse events.

CONCLUSIONS Prolotherapy resulted in clinically meaningful sustained improvement of pain, function, and stiffness scores for knee osteoarthritis compared with blinded saline injections and at-home exercises.

  • randomized controlled trial
  • osteoarthritis
  • knee
  • prolotherapy
  • dextrose
  • Received for publication March 21, 2012.
  • Revision received September 28, 2012.
  • Accepted for publication October 19, 2012.
  • © 2013 Annals of Family Medicine, Inc.
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The Annals of Family Medicine: 11 (3)
The Annals of Family Medicine: 11 (3)
Vol. 11, Issue 3
May/June 2013
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Dextrose Prolotherapy for Knee Osteoarthritis: A Randomized Controlled Trial
David Rabago, Jeffrey J. Patterson, Marlon Mundt, Richard Kijowski, Jessica Grettie, Neil A. Segal, Aleksandra Zgierska
The Annals of Family Medicine May 2013, 11 (3) 229-237; DOI: 10.1370/afm.1504

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Dextrose Prolotherapy for Knee Osteoarthritis: A Randomized Controlled Trial
David Rabago, Jeffrey J. Patterson, Marlon Mundt, Richard Kijowski, Jessica Grettie, Neil A. Segal, Aleksandra Zgierska
The Annals of Family Medicine May 2013, 11 (3) 229-237; DOI: 10.1370/afm.1504
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