EFFICACY OF PROLOTHERAPY FOR OSTEOARTHRITIS: A SYSTEMATIC REVIEW

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. LAY ABSTRACT Osteoarthritis is a long-term chronic illness defined by the degeneration of cartilage in joints, causing bones to rub together and causing stiffness, discomfort, and decreased movement. Current treatment options for osteoarthritis do not address the fundamental cause. Dextrose prolotherapy is a potential alternative approach for OA, due to its capacity to help tissue regeneration, improve clinical symptoms, and repair damaged tissue structures, which are pathogenic in osteoarthritis. Despite several comparison studies, the superiority of dextrose prolotherapy in osteoarthritis remains equivocal due to contradictory outcomes. Based on this review, dextrose prolotherapy should be considered as a possible treatment for osteoarthritis.