Meta-analysis of clinical trials focusing on hypertonic dextrose prolotherapy (HDP) for knee osteoarthritis

Hypertonic dextrose prolotherapy (HDP) is an injection of a concentrated dextrose solution for the purpose of local treatment of musculoskeletal pain and possible enhancement of repair mechanisms. This systematic review and meta-analysis examines the clinical utility of HDP injection for treatment o...

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Bibliographic Details
Published in:Aging clinical and experimental research 2022-04, Vol.34 (4), p.715-724
Main Authors: Wang, Jun, Liang, Jie, Yao, Jin, Song, Hai Xin, Yang, Xiao Tian, Wu, Fang Chao, Ye, Ye, Li, Jian Hua, Wu, Tao
Format: Article
Language:English
Subjects:
Aging
Arthritis
Cartilage
Clinical trials
Exercise
Geriatrics/Gerontology
Hyaluronic acid
Knee
Medicine
Medicine & Public Health
Meta-analysis
Osteoarthritis
Pain
Rehabilitation
Review
Systematic review
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Summary:Hypertonic dextrose prolotherapy (HDP) is an injection of a concentrated dextrose solution for the purpose of local treatment of musculoskeletal pain and possible enhancement of repair mechanisms. This systematic review and meta-analysis examines the clinical utility of HDP injection for treatment of knee osteoarthritis (OA). Randomized controlled trials (RCTs) utilizing HDP to treat knee OA were retrieved from MEDLINE, EMBASE, and Cochrane Library (CENTRAL). Identification and inclusion of RCTs utilizing intra-articular and extra-articular administration of HDP vs administration of other injectate or physical therapy as control for knee OA were included. Primary clinical outcomes were changes in knee WOMAC, pain and function score. Secondary outcomes were adverse events related to HDP. For continuous outcomes with same or different measurements, we calculated, respectively the weighted mean difference (WMD) or the standardized mean difference (SMD), respectively. Results were pooled using DerSimonian and Laird random effect models across the included studies and heterogeneity between studies was estimated using the I 2 index. Five studies comprising a total of 319 treated patients met inclusion criteria and were included in the final analysis. At a mean of 22.8 weeks follow-up, HDP treatment significantly improved total WOMAC score (WMD = 13.77, 95% CI: 6.75–20.78; p  
ISSN:1720-8319
1594-0667
1720-8319
DOI:10.1007/s40520-021-01963-3