A Comparative Study of Short-Term Efficacy of Intra-articular Hypertonic Saline and Hypertonic Dextrose Prolotherapy in Knee Osteoarthritis: A randomized controlled trial (RCT)

Knee osteoarthritis (KOA) is a common public health disease with an increasing prevalence. It is one of the leading causes of disability, especially in the elderly. Intra-articular hypertonic dextrose prolotherapy is one of the therapies used for KOA. There have been some articles indicating that patients receiving intra-articular normal saline as a control group of the article had improvement as well. The aim of this randomized clinical trial study was to evaluate the efficacy of intra-articular hypertonic saline in comparison with hypertonic dextrose prolotherapy in treatment of KOA. A total of 54 patients with KOA were randomized in two groups: hypertonic dextrose (28 patients) and hypertonic saline groups (26 patients). All patients received three intra-articular injections of either hypertonic dextrose or hypertonic saline at two weeks intervals. The values obtained by visual analogue pain scale (VAS), Oxford knee scale (OKS), and Western Ontario McMaster University Osteoarthritis Index (WOMAC) questionnaire were the outcome measures which were evaluated before, as well as 2 and 4 weeks after the injections. The data were analyzed using t-test and repeated measurement tests. Both groups revealed improvements in outcome measures after 2 and 4 weeks of intervention. However, no statistically significant difference was found between the two groups. We concluded that the intra-articular injection of hypertonic dextrose and hypertonic saline are both effective in the management of KOA. Hypertonic saline can be considered as another medical agent in management of KOA. However, further studies are suggested to evaluate its long-term effects.