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Question clinique
Does injecting hypertonic dextrose into the knee improve pain and function in patients with degenerative joint disease?
L’Essentiel
In this study, serial injections of hypertonic dextrose into the knee statistically improved pain and function to a greater degree than serial injections of normal saline, but these improvements were not clinically important. 1b
Référence
Plan de l'etude: Randomized controlled trial (double-blinded)
Financement: Self-funded or unfunded
Cadre: Outpatient (primary care)
Sommaire
These authors recruited patients with confirmed degenerative joint disease (DJD) of the knee and moderately severe pain who attended a university primary care clinic in Hong Kong. Most studies of prolotherapy use a 25% dextrose solution injected both intra- and extra-articularly. In this study, the authors randomized patients to receive intra-articular injections of hypertonic dextrose (5 mL 25% dextrose; n = 38) or normal saline (5 mL; n = 38) at 0, 4, 8, and 16 weeks. The researchers evaluated each patient using a variety of standardized scales and clinical measures. The participants were an average of 63.2 years of age, 71% were female, 21% were overweight, and 46% were obese. After 1 year, the patients who received prolotherapy had a greater degree of improvement in the overall Western Ontario McMaster University Osteoarthritis Index (WOMAC) and its various subscales. Most of the improvements occurred before 16 weeks. However, the net differences were in the range of 10 points, which is below the minimal clinically important difference for the WOMAC. Two patients who received prolotherapy and 6 patients who received saline reported unspecified serious adverse events.
Reviewer
Henry C. Barry, MD, MS
Professor
Michigan State University
East Lansing, MI
Commentaires
Great article
Intra-articular hypertonic dextrose injections marginally improve pain and function in patients with knee osteoarthritis
Good read
Intra-articular hypertonic dextrose injections marginally improve pain and function in patients with knee osteoarthritis