The effect of hypertonic dextrose prolotherapy on knee osteoarthritis outpatients in Dr. Ramelan Navy Hospital Surabaya: case series

Abstract

Background: The high use and pressure on the knee cause osteoarthritis to occur frequently. Prolotherapy is a non-surgical injection therapy used to treat chronic pain in musculoskeletal conditions, including knee OA. This solution can create local irritation, inflammation, and tissue regeneration, thereby increasing the strength of damaged ligaments, tendons, and intra-articular structures. Therefore, the aim of this research is to assess the changes in VAS and WOMAC scores, as well as plain radiographs of knee OA patients after hypertonic dextrose prolotherapy. Methods: This experimental case series was done at the Physical Medicine and Rehabilitation Polyclinic of dr. Ramelan Navy Hospital Surabaya from December 2021 to April 2022, by giving hypertonic dextrose prolotherapy injection intraarticularly to 3 knee OA subjects using a 22G or 23G needle. This procedure was performed 3 times on each subject, with an interval of 4 weeks each. The assessments were carried out with VAS and WOMAC scores, as well as plain radiographs of the knees before the procedure and 1 month after the third injection for evaluation. Results: In all 3 subjects, the knee joint spaces were slightly widened on plain radiographs, as well as decreased VAS and WOMAC scores after injection. Conclusion: Hypertonic dextrose prolotherapy here had minimal side effects, affordable prices, and a fast process. It also causes a reduction in pain and joint stiffness and causes functional improvement. Prolotherapy may be considered a therapy for knee OA patients.