Global, regional, and national incidence, prevalence, and years lived with disability for 354 Diseases and Injuries for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease...
Global, regional, and national incidence, prevalence, and years lived with disability for 354 Diseases and Injuries for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017. Doi:10.1016/S0140-673632279-7[/ref] There are a wide variety of treatment options including oral and topical medications, bracing, intra-articular injections and surgical procedures. Regarding injections, options include corticosteroids, NSAIDS, hyaluronic acid and prolotherapy among others.
"A Comprehensive Update of Prolotherapy in the Management of Osteoarthritis of the Knee." Orthopedic Reviews 14.4: 33921.[/ref] Prolotherapy is a regenerative therapy which uses an injectant to promote regeneration of tissue within the joint. Most commonly, this is dextrose. The exact mechanism of action is not entirely clear.
Conceptually, the injectate initiates a local inflammatory response leading to a healing cascade. This subsequently leads to release of growth factors, proliferation of fibroblasts, and deposition of collagen, strengthening the joint and reducing pain. 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee.
Doi:10.1002/acr.24131[/ref] It can also be considered for patients with enthesopathies, tendinopathies and ACL laxity. Prolotherapy should be considered in patients who have failed to improve with other conservative treatments such as physical therapy and NSAIDS. Chronic sprains and strains also may benefit from prolotherapy.
Hypertonic dextrose is the most commonly used injectant with concentrations ranging from 10% to 25% which can be diluted with local anesthetic. Dextrose is largely considered safe and 25% appears to be the favored concentration in some studies. Sodium morrhuate (5%) or DPG (dextrose, phenol, glycerin) can also be considered, especially if patient does not improve with dextrose.[ref]Linetsky FS, Miguel R, Saberski L.
If you are experiencing symptoms that may be related to dextrose prolotherapy for knee osteoarthritis, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.
*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*
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