Comparison of Two Knee Prolotherapy Injection Methods in Reducing Pain and Improving the Function of Patients with Knee Osteoarthritis

The present chapter sought to compare the effect of periarticular versus intraarticular prolotherapy on pain and disability in patients with knee Osteoarthritis (OA).

To compare the effect of periarticular versus intra-articular prolotherapy on pain and disability in patients with knee OA.

Osteoarthritis (OA) is a degenerative disease that manifests mainly with painful joints, articular stiffness, and decreased function. t is often described as a chronic degenerative disease and thought by many to be an inevitable consequence of growing old. This randomized souble blind controlled clinical trial was carried out at Single-center, university hospital (Imam Hossein Hospital, Tehran, Iran). A total of 104 patients with chronic knee OA were enrolled. In the intra-articular group, 8 mL of 10% dextrose and 2 mL of 2% lidocaine were injected. Injections were repeated at 1 and 2 weeks after the first injection. In the periarticular group, 5 mL of 20% dextrose and 5 mL of 1% lidocaine were injected subcutaneously at 4 points in the periarticular area. Pain and disability, as assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), were recorded at each follow-up visit at 1, 2, 3, 4, and 5 months post-injection. The visual analog scale score was significantly lower in the periarticular compared with the intra-articular group at the 2-, 3-, 4-, and 5-month visits but not at 1 month. Morning stiffness and difficulty in rising from sitting were improved in both groups and were not significantly different in the periand intra-articular groups.Both groups showed improvements in their scores for pain, joint locking, and limitation. Pain in both sitting and standing positions, difficulty climbing stairs or walking on flat surfaces, and these symptoms all improved in both groups from 1 to 5 months after treatment. Periarticular injections around the knee joint ignite the inflammatory reaction in the vicinity of joint capsule. The infiltration of inflammatory cells and cytokines to the periarticular area may enhance blood perfusion in the capsular joint, increase nourishment to the cartilaginous tissue, and enhance regeneration.

Periarticular prolotherapy has comparable effects on pain and disability due to knee OA to intra-articular injections while avoiding risks of complications.