Blog | Thursday, May 23, 2013

QD: News Every Day--Dextrose injections for knee osteoarthritis aids pain, function


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

Researchers randomly assigned 90 adults with at least 3 months of painful knee osteoarthritis to blinded injection with dextrose prolotherapy or saline, or to at-home exercise. Extra- and intra-articular injections were done at 1, 5, and 9 weeks with as-needed treatments at weeks 13 and 17.

Outcome measures included knee pain, post-procedure opioid use for injection-related pain, and patient satisfaction. Results appeared in the May/June issue of Annals of Family Medicine.

No baseline differences existed between groups. All groups reported improved for a composite score on the Western Ontario McMaster University Osteoarthritis Index (WOMAC; 100 points) scores compared with baseline status (P less than <.01) at 52 weeks. WOMAC scores for patients receiving dextrose prolotherapy improved more (P less than .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).

Postprocedure opioid medication addressed injection-related pain, satisfaction with the procedure was high and there were no adverse events, researchers noted.

Researchers wrote, "Its use in clinical practice is relatively uncomplicated; prolotherapy is performed in the outpatient setting without ultrasound guidance using inexpensive solutions. The knee protocol is easy to learn and requires less than 15 minutes to perform; continuing medical education is provided in major university and national physician organizations settings."