These data suggest that prolotherapy in this primary care clinic is feasible and acceptable in patients with Knee osteoarthritis.

These data suggest that prolotherapy in this primary care clinic is feasible and acceptable in patients with Knee osteoarthritis.

PMID: 

J Altern Complement Med. 2019 Apr ;25(4):406-412. Epub 2019 Jan 28. PMID: 30688517

Abstract Title: 

Dextrose Prolotherapy for Symptomatic Knee Osteoarthritis: Feasibility, Acceptability, and Patient-Oriented Outcomes in a Pilot-Level Quality Improvement Project.

Abstract: 

OBJECTIVES: Knee osteoarthritis (KOA) is a growing health problem with limited nonsurgical treatment options. Prolotherapy is an injection-based technique for chronic KOA pain; health plan coverage is limited, presenting an access barrier. A local health plan recently included coverage for prolotherapy for KOA, but uptake and treatment response in routine care are unknown. The authors conducted a pilot-level quality improvement (QI) project to explore the feasibility, acceptability, and effects of prolotherapy for painful KOA in a primary care setting.DESIGN: QI prospective case series.SETTING/LOCATION: Outpatient: invitation letters were sent to symptomatic KOA patients with a primary care provider whose health plan covered prolotherapy.SUBJECTS: Primary care patients with KOA.INTERVENTION: Intra- and extra-articular prolotherapy injections: patients received up to six prolotherapy sessions.OUTCOME MEASURES: Primary: Feasibility: response rate to invitation to utilize prolotherapy. Acceptability: patient adherence to, and satisfaction with, three or more prolotherapy sessions. Secondary: Survey based (the Western Ontario McMaster University Osteoarthritis Index, WOMAC, 0-100; EuroQOL 5-D). Objectively assessed: function (30-sec chair stand, 4 × 10 m walk, 9-step stair-climb), overall activity (ActiGraph wGT3X accelerometer), treadmill gait analysis, and preferred walking speed. Outcome analysis (paired t-test) was per protocol, comparing follow-up and baseline outcome data at ∼8 months.RESULTS: Thirty-nine patients were invited, 11 responded, and 7 patients (59.6 ± 9.3 years, 6 female) received 5.0 ± 1.1 prolotherapy sessions. Satisfaction was high. Their WOMAC scores improved by 27.6 ± 19.5 points (p = 0.02) at 8.4 months. Functional testing improved by 8.0 ± 3.6 sec (p = 0.003) in the 4 × 10 m walk. There were no groupdifferences between baseline and follow-up in chair stand, stair-climb, accelerometry, or gait outcomes. Five patients increased their preferred walking speed (p = 0.001).CONCLUSIONS: These data suggest that prolotherapy in this primary care clinic is feasible and acceptable. Self-reported improvement is similar to that of efficacy studies; office-based, objectively assessed functional assessment can be performed. Further evaluation is warranted.

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