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. 2023 Feb 27:55:jrm00372.
doi: 10.2340/jrm.v55.2572.

Efficacy of Prolotherapy for Osteoarthritis: A Systematic Review

Yose Waluyo  1 , Sari Rajwani Artika  2 , Insani Nanda Wahyuni  2 , Andi Muh Aunul Khaliq Gunawan  3 , Ahmad Taufik Fadillah Zainal  3
Affiliations

Efficacy of Prolotherapy for Osteoarthritis: A Systematic Review

Yose Waluyo et al. J Rehabil Med. .

Abstract

Objective: Current treatments for osteoarthritis do not resolve the underlying cause. Dextrose prolotherapy is an alternative method that has been proposed for treatment of osteoarthritis, due to its ability to aid tissue regeneration, improve clinical manifestations, and repair damaged tissue structures, which are pathological conditions in osteoarthritis. The aim of this systematic review was to evaluate the efficacy of dextrose prolotherapy compared with other interventions in the management of osteoarthritis.

Methods: Electronic databases PubMed, Google Scholar, Cochrane, and BioMed Central were searched from inception to October 2021. Search terms included [(prolotherapy) OR (prolotherapies) OR (dextrose prolotherapy)] AND [(osteoarthritis) OR (osteoarthritides) OR (knee osteoarthritis) OR (hip osteoarthritis) OR (hand osteoarthritis) OR (shoulder osteoarthritis)]. Randomized controlled trials that compared the use of dextrose prolotherapy with other interventions (injection, placebo, therapy, or conservative treatment) in the treatment of osteoarthritis were included. Potential articles were screened for eligibility, and data were extracted by all authors. Risk of bias was assessed using the Cochrane Risk of Bias tool. Study population, methods, and results data were extracted and tabulated by 3 authors.

Results: 12 studies reported that DPT was as effective or even more effective in improving functional outcomes compared with other interventions whilst others found that HA, PRP, EP, and ACS were more effective. 14 studies assessed the effectiveness of DPT and ten of them reported that DPT was more effective in reducing pain compared with other interventions.

Conclusion: Dextrose prolotherapy in osteoarthritis confers potential benefits for pain and functional outcomes, but this systematic review found that the studies to date are at high risk of bias.

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Figures

Fig. 1
Fig. 1
Flow chart. OA: osteoarthritis; KOA: knee osteoarthritis; RCT: randomized controlled trial.
Fig. 2
Fig. 2
Risk of bias summary.
Fig. 3
Fig. 3
Risk of bias graph.
See this image and copyright information in PMC

References

    1. World Health Organization (WHO) . Essential medicines and health products – priority diseases and reasons for inclusion – osteoarthritis. Geneva: WHO; 2013; 12: 6–8.
    1. Kolasinski SL, Neogi T, Hochberg MC, Oatis C, Guyatt G, Block J, et al. 2019. American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis Rheumatol 2020; 72: 220–233. - PMC - PubMed
    1. Rahimzadeh P, Imani F, Faiz SHR, Entezary SR, Zamanabadi MN, Alebouyeh MR. The effects of injecting intra-articular platelet-rich plasma or prolotherapy on pain score and function in knee osteoarthritis. Clin Interv Aging 2018; 13: 73–79. - PMC - PubMed
    1. Linetsky FS, Manchikanti L. Regenerative injection therapy for axial pain. Tech Reg Anesth Pain Manag 2005; 9: 40–49.
    1. Goswami A. Prolotherapy. J Pain Palliat Care Pharmacother 2012; 26: 376–378. - PubMed

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