Is Regenerative Injection Therapy (Prolotherapy) Effective at Reducing Pain Associated With Knee Osteoarthritis?

Objective: The objective of this selective EBM review is to determine whether or not “Is regenerative injection therapy (prolotherapy) effective at reducing pain associated with knee osteoarthritis?” Study Design: Review of all English language primary studies published in 2012 and 2013. Data Sources: One randomized control trial, one randomized crossover study and one single-arm uncontrolled study were found using PubMed and Ebscohost. Outcomes Measured: Clinical outcome for all three articles was measured using the Western Ontario McMaster University Osteoarthritis Index (WOMAC); which specifically focuses on quality of life, function, and pain reduction after the use of prolotherapy versus the saline placebo. Results: In a randomized control study (RCT) by Rabago et al. (2012) they found that patients given prolotherapy sustained significant improvement of pain, function, and stiffness scores for knee osteoarthritis compared with the blinded saline injection group. The randomized crossover study by Dumais et al. also came to the conclusion that prolotherapy is associated with a marked reduction in symptoms that was sustained for over 24 weeks. The Rabago et al. (2013) singlearm uncontrolled study also found similar results; 36% improvement on the WOMAC. Conclusions: Both randomized controlled trials and the single-arm uncontrolled studies included in this review indicate that regenerative injection therapy, also known as RIT or prolotherapy, is an effective treatment for knee osteoarthritis in regards to quality of life, pain, and function.