Treating Osteoarthritic Joints Using Dextrose Prolotherapy and Direct Bone Marrow Aspirate Injection Therapy

Osteoarthritis is a chronic, progressive disease of the articular joints, and to date, has no cure or effective longterm treatment. Objective: To determine if bone marrow prolotherapy (BMP), a combined treatment protocol employing separate injections of hypertonic dextrose prolotherapy and bone marrow aspirate, would be effective as a means of reducing joint pain and improving function in osteoarthritic joints. Design: Patients with a clinical diagnosis of radiographic osteoarthritis who visited our pain clinic and underwent BMP treatments (N = 24, mean age 64.9) were asked to complete a questionnaire assessing their condition before and after treatment. Methods: BMP treatments (average 3.6) were conducted at 6 to 8 week intervals and involved autologous harvesting and aspiration of the patient’s tibial bone marrow, after which a hypertonic dextrose solution was injected at sites in and around the index joint (prolotherapy), followed by injections of the bone marrow aspirate directly into and around the joint. At 6 months post-treatment, patients were e-mailed a questionnaire asking them to rate their condition before and after BMP treatment in terms of pain levels at rest, performing activities of daily living, and during exercise (Visual Analog Pain Scale), as well as their degree of stiffness, range of motion, and level of crepitus. Changes in the self-reported scores of these variables for each patient were analyzed to determine the effectiveness of BMP treatment. Data were obtained by comparing the differences between baseline and posttreatment scores and analyzed utilizing a two-tailed paired t test. Results: Patient-reported improvements in pain relief and joint function were statistically significant (P < .001), as were gains in activities of daily living, exercise ability, and range of motion and losses in stiffness and crepitus. No adverse events occurred. Conclusion: Our survey of patientreported outcomes supports the use of BMP as an effective therapy for treating osteoarthritis and suggests that BMP has potential for enhancing the quality of life of individuals with the disease.