Comparison between 25% dextrose prolotherapy and single dose of platelet rich plasma in the management of pain and improvement of functional outcome in patients suffering from primary knee osteoarthritis: a randomized controlled trial
Keywords:Prolotherapy, WOMAC, KL grading, PRP
Background: One of the most prevalent and disabling diseases worldwide, which decreases patients' quality of life (QoL) is knee osteoarthritis. However, pharmacological and non-pharmacological treatments, apart from complications, could not desirably control the disease. Limited studies are available in management of primary osteoarthritis of knee with prolotherapy with 25% dextrose and platelet rich plasma (PRP). Objective was to compare between 25% dextrose prolotherapy and single dose of PRP injection in the management of pain and improvement of functional outcome in patients suffering from primary knee osteoarthritis.
Methods: A comparative study was conducted to see the effectiveness of 25% dextrose prolotherapy and PRP in primary osteoarthritis (OA) of knee in the management of pain and improvement of functional outcome in sixty-six patients in age group of 50 to 70 years attending PMR department OPD, RIMS, Imphal between october2018 to April 2020. The first group received 6 ml injections of 25% dextrose 3 times at baseline, 1 month and 4th month, whereas the 2nd group received single dose of 5ml PRP at baseline.
Results: In both the groups 50 mg of tramadol tablet and isometric strengthening exercise of quadriceps was given. Assessment was done at baseline, at 1, 4 and 8 months by visual analogue scale (VAS) and western Ontario and McMaster university arthritis (WOMAC) index. Statistically significant improvement was noted in VAS (5.91±0.82 to 2.65±0.94) and WOMAC score (45.25±6.68 to 20.25±7.67) at end of 8 month in first group.
Conclusion: It was concluded that 25% dextrose was more effective than in management of primary osteoarthritis of knee.
Das S. Manual of Rheumatology. Osteoarthritis. (3rd ed.). Mumbai: Indian Rheumatology Association. 2009;243-8.
Alderman D. A reasonable and conservative approach to knee tendonitis/tendonosis, sprain-strains, instability, diagnosis of meniscal tear, patellofemoral pain syndrome including chrondromalacia-patellae, degenerative joint disease, and osteoarthritis pain. Pract Pain Management. 2007;7:70-1.
Baurer B. Prolotherapy: solution to low back pain. Available from http://www.mayoclinic.org/prolotherapy/expert-answers/faq-20058347. Accessed on 20/7/2020.
Forogh B, Mianehsaz E, Shoaee S, Ahadi T, Raissi GR, Sajadi S. Effect of single injection of platelet-rich plasma in comparison with corticosteroid on knee osteoarthritis: a double-blind randomized clinical trial. J Sports Med Phys Fitness. 2016;56(7-8):901-8.
Eslamian F, Amouzandeh B. Therapeutic effects of prolotherapy with intraarticular dextrose injection in patients with moderate knee osteoarthritis: a single-arm study with 6 months follow up. Therap adv musculoskeletal dis. 2015;7(2):35-44.
Soliman DMI, Sherif NM, Omar OH, Zohiery EIAK. Healing effects of prolotherapy in treatment of knee osteoarthritis healing effects of prolotherapy in treatment of knee osteoarthritis. Egypt Rheumatol Rehabi. 2016;43(2):47-52.