• Regina Wing Shan Sit, Ricky Wing Keung Wu, David Rabago, Kenneth Dean Reeves, Dicken Cheong Chun Chan, Yip Benjamin Hon Kei BHK Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong., Vincent Chi Ho Chung, and Samuel Yeung Shan Wong.
• Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong reginasit@cuhk.edu.hk.
• Ann Fam Med. 2020 May 1; 18 (3): 235-242.

PurposeTo test the efficacy of intra-articular hypertonic dextrose prolotherapy (DPT) vs normal saline (NS) injection for knee osteoarthritis (KOA).MethodsA single-center, parallel-group, blinded, randomized controlled trial was conducted at a university primary care clinic in Hong Kong. Patients with KOA (n = 76) were randomly allocated (1:1) to DPT or NS groups for injections at weeks 0, 4, 8, and 16. The primary outcome was the Western Ontario McMaster University Osteoarthritis Index (WOMAC; 0-100 points) pain score. The secondary outcomes were the WOMAC composite, function and stiffness scores; objectively assessed physical function test results; visual analogue scale (VAS) for knee pain; and EuroQol-5D score. All outcomes were evaluated at baseline and at 16, 26, and 52 weeks using linear mixed model.ResultsRandomization produced similar groups. The WOMAC pain score at 52 weeks showed a difference-in-difference estimate of -10.34 (95% CI, -19.20 to -1.49, P = 0.022) points. A similar favorable effect was shown on the difference-in-difference estimate on WOMAC function score of -9.55 (95% CI, -17.72 to -1.39, P = 0.022), WOMAC composite score of -9.65 (95% CI, -17.77 to -1.53, P = 0.020), VAS pain intensity score of -10.98 (95% CI, -21.36 to -0.61, P = 0.038), and EuroQol-5D VAS score of 8.64 (95% CI, 1.36 to 5.92, P = 0.020). No adverse events were reported.ConclusionIntra-articular dextrose prolotherapy injections reduced pain, improved function and quality of life in patients with KOA compared with blinded saline injections. The procedure is straightforward and safe; the adherence and satisfaction were high.© 2020 Annals of Family Medicine, Inc.

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