Abstract
Knee osteoarthritis (OA) is one of the most common cartilage degenerative disorders that is a major problem because it causes chronic pain and disability. Therefore the method of treatment and prevention of old age is a big challenge. The results of Dextrose Prolotherapy compared to Triamcinolone therapy research are still varied. Objective: to compare the effectiveness of Dextrose Prolotherapy and Triamcinolone Acetonide (TA) in the treatment of moderate knee knee OA.True experimental single blind study, at the Neurology Polyclinic Dr. Saiful Anwar General Hospital Malang for 6 months (July-December 2019). Group I; Dextrose Prolotherapy (15%) intraarticularly injected 3 times every 4 weeks and group II; TA one- time intraarticular injection. The parameters studied were The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Score, Numeric Rating Scale (NRS), and Range of Motion (ROM), weeks 0, 4, 8, 12 and 24. Forty samples consisted of; the 20 samples of the Dextrose Prolotherapy group consisted of; male: female = 2 (10%): 18 (90%), age 62.4 + 7.28, BMI 25.6 + 3.69 kg / m2, pain duration 22.35 + 20.10 months, history of physiotherapy 40.27 + 20.79 times. Kellgren–Lawrence osteoarthritis severity grade II; 17 (85%), grade III 3 (15%). TA group; male: female = 5 (25%):15 (75%), age 62.5 + 9.02, BMI 28.4 + 5.01 kg/m2, pain duration 15.95 + 16.55 months, history of physiotherapy 34 + 24.87 times. Kellgren – Lawrence osteoarthritis severity grade II; 18 (90%), grade III; 2 (10%). Comparison of NRS at rest Dextrose Prolotherapy vs TA of week 4 (2.60 vs 1.25), week 8 (1.65 vs 1.40), week 12 (0.8 vs 2.05), week 24 (0.75 vs 3.35). Comparison of NRS during activity Dextrose Prolotherapy vs TA week 4 (4.45 vs 3.35), week 8 (3.25 vs 3.55), week 12 (2.55 vs 4.30), week 24 (2.55 vs 5.80). Comparison of ROM flexion Dextrose Prolotherapy vs TA week 4 (127.05° vs 123.60°), week 8 (130.85° vs 122.95°), week 12 (130.85° vs 122.95°), week 24 (131.05° vs 122.10°). Comparison of WOMAC score Dextrose Prolotherapy vs TA week 4 (30.05 vs 22.45), week 8 (22.90 vs 23.95), week 12 (19.30 vs 29.05), week 24 (18.95 vs 35.40). Intraarticular Injection Dextrose Prolotherapy is more effective for the long term based on pain scale NRS, WOMAC score and ROM. Whereas short-term TA is more effective than Dextrose Prolotherapy.
Highlights
Osteoarthritis (OA) is a disease that is needed at an age caused by degenerative processes and recovery in articular subcondral tissue and cartilage resulting in biomechanical changes which cause pain, stiffness, and replacement of articular function
In this study we found evidence of a longer effect to support the use of intraarticular injection of Dextrose Prolotherapy over Triamcinolone Acetonide for the treatment of knee OA in terms of pain relief and function
After 24 weeks of treatment, both injection groups can reduce the severity of symptoms, can increase joint Range of Motion (ROM) and improve WOMAC score, but Dextrose Prolotherapy seems to be more effectiveOur findings are consistent with the results of several previous studies
Summary
Osteoarthritis (OA) is a disease that is needed at an age caused by degenerative processes and recovery in articular subcondral tissue and cartilage resulting in biomechanical changes which cause pain, stiffness, and replacement of articular function. Knee osteoarthritis is a major problem in the world because it is the second leading cause of joint pain and disability in the elderly in western countries after cardiovascular disease [1,2,3]
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