{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T21:55:33Z","timestamp":1791582933020,"version":"4.3.4"},"reference-count":50,"publisher":"MJS Publishing, Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2023,2,27]],"date-time":"2023-02-27T00:00:00Z","timestamp":1677456000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JRM"],"abstract":"<jats:p>Objective: Current treatments for osteoarthritis do not resolve the underlying cause. Dextrose prolotherapy is an alternative method that has been proposed for treatment of osteoarthritis, due to its ability to aid tissue regeneration, improve clinical manifestations, and repair damaged tissue structures, which are pathological conditions in osteoarthritis. The aim of this systematic review was to evaluate the efficacy of dextrose prolotherapy compared with other interventions in the management of osteoarthritis.Methods: Electronic databases PubMed, Google Scholar, Cochrane, and BioMed Central were searched from inception to October 2021. Search terms included [(prolotherapy) OR (prolotherapies) OR (dextrose prolotherapy)] AND [(osteoarthritis) OR (osteoarthritides) OR (knee osteoarthritis) OR (hip osteoarthritis) OR (hand osteoarthritis) OR (shoulder osteoarthritis)]. Randomized controlled trials that compared the use of dextrose prolotherapy with other interventions (injection, placebo, therapy, or conservative treatment) in the treatment of osteoarthritis were included. Potential articles were screened for eligibility, and data were extracted by all authors. Risk of bias was assessed using the Cochrane Risk of Bias tool. Study population, methods, and results data were extracted and tabulated by 3 authors.Results: 12 studies reported that DPT was as effective or even more effective in improving functional outcomes compared with other interventions whilst others found that HA, PRP, EP, and ACS were more effective. 14 studies assessed the effectiveness of DPT and ten of them reported that DPT was more effective in reducing pain compared with other interventions.Conclusion: Dextrose prolotherapy in osteoarthritis confers potential benefits for pain and functional outcomes, but this systematic review found that the studies to date are at high risk of bias.\nLAY ABSTRACTOsteoarthritis is a long-term chronic illness defined by the degeneration of cartilage in joints, causing bones to rub together and causing stiffness, discomfort, and decreased movement. Current treatment options for osteoarthritis do not address the fundamental cause. Dextrose prolotherapy is a potential alternative approach for OA, due to its capacity to help tissue regeneration, improve clinical symptoms, and repair damaged tissue structures, which are pathogenic in osteoarthritis. Despite several comparison studies, the superiority of dextrose prolotherapy in osteoarthritis remains equivocal due to contradictory outcomes. Based on this review, dextrose prolotherapy should be considered as a possible treatment for osteoarthritis.<\/jats:p>","DOI":"10.2340\/jrm.v55.2572","type":"journal-article","created":{"date-parts":[[2023,2,27]],"date-time":"2023-02-27T10:12:13Z","timestamp":1677492733000},"page":"jrm00372","source":"Crossref","is-referenced-by-count":39,"title":["Efficacy of Prolotherapy for Osteoarthritis: A Systematic Review"],"prefix":"10.2340","volume":"55","author":[{"given":"Yose","family":"Waluyo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sari Rajwani","family":"Artika","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"family":"Insani Nanda Wahyuni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andi Muh Aunul Khaliq","family":"Gunawan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad Taufik Fadillah","family":"Zainal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1183","published-online":{"date-parts":[[2023,2,27]]},"reference":[{"key":"28296","unstructured":"World Health Organization (WHO). Essential medicines and health products - priority diseases and reasons for inclusion - osteoarthritis. Geneva: WHO; 2013; 12: 6-8."},{"key":"28297","doi-asserted-by":"crossref","unstructured":"Kolasinski SL, Neogi T, Hochberg MC, Oatis C, Guyatt G, Block J, et al. 2019 American College of Rheumatology\/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis Rheumatol 2020; 72: 220-233.","DOI":"10.1002\/art.41142"},{"key":"28298","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1002\/art.41142","DOI":"10.1002\/art.41142"},{"key":"28299","doi-asserted-by":"crossref","unstructured":"Rahimzadeh P, Imani F, Faiz SHR, Entezary SR, Zamanabadi MN, Alebouyeh MR. The effects of injecting intra-articular platelet-rich plasma or prolotherapy on pain score and function in knee osteoarthritis. Clin Interv Aging 2018; 13: 73-79.","DOI":"10.2147\/CIA.S147757"},{"key":"28300","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.2147\/CIA.S147757","DOI":"10.2147\/CIA.S147757"},{"key":"28301","doi-asserted-by":"crossref","unstructured":"Linetsky FS, Manchikanti L. Regenerative injection therapy for axial pain. Tech Reg Anesth Pain Manag 2005; 9: 40-49.","DOI":"10.1053\/j.trap.2005.01.004"},{"key":"28302","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1053\/j.trap.2005.01.004","DOI":"10.1053\/j.trap.2005.01.004"},{"key":"28303","doi-asserted-by":"crossref","unstructured":"Goswami A. Prolotherapy. J Pain Palliat Care Pharmacother 2012; 26: 376-378.","DOI":"10.3109\/15360288.2012.734900"},{"key":"28304","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.3109\/15360288.2012.734900","DOI":"10.3109\/15360288.2012.734900"},{"key":"28305","doi-asserted-by":"crossref","unstructured":"Distel LM, Best TM. Prolotherapy: a clinical review of its role in treating chronic musculoskeletal pain. PM&R 2011; 3: S78-S81.","DOI":"10.1016\/j.pmrj.2011.04.003"},{"key":"28306","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1016\/j.pmrj.2011.04.003","DOI":"10.1016\/j.pmrj.2011.04.003"},{"key":"28307","doi-asserted-by":"crossref","unstructured":"DeChellis DM, Cortazzo MH. Regenerative medicine in the field of pain medicine: prolotherapy, platelet-rich plasma therapy, and stem cell therapy - theory and evidence. Tech Reg Anesth Pain Manag 2011; 15: 74-80.","DOI":"10.1053\/j.trap.2011.05.002"},{"key":"28308","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1053\/j.trap.2011.05.002","DOI":"10.1053\/j.trap.2011.05.002"},{"key":"28309","doi-asserted-by":"crossref","unstructured":"Higgins JPT, Altman DG, Gotzsche PC, Juni P, Moher D, Oxman AD, et al. The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. BMJ 2011; 343: d5928-d5928.","DOI":"10.1136\/bmj.d5928"},{"key":"28310","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1136\/bmj.d5928","DOI":"10.1136\/bmj.d5928"},{"key":"28311","doi-asserted-by":"crossref","unstructured":"Hashemi M, Jalili P, Mennati S, Koosha A, Rohanifar R, Madadi F, et al. The effects of prolotherapy with hypertonic dextrose versus prolozone (intraarticular ozone) in patients with knee osteoarthritis. Anesthesiol Pain Med 2015; 5: 5-8.","DOI":"10.5812\/aapm.27585"},{"key":"28312","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.5812\/aapm.27585","DOI":"10.5812\/aapm.27585"},{"key":"28313","doi-asserted-by":"crossref","unstructured":"Rabago D, Patterson JJ, Mundt M, Kijowski R, Grettie J, Segal NA, et al. Dextrose prolotherapy for knee osteoarthritis: a randomized controlled trial. 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Iran J Allergy, Asthma Immunol 2020; 19: 243-252.","DOI":"10.18502\/ijaai.v19i3.3452"},{"key":"28318","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.18502\/ijaai.v19i3.3452","DOI":"10.18502\/ijaai.v19i3.3452"},{"key":"28319","doi-asserted-by":"crossref","unstructured":"Waluyo Y, Budu, Bukhari A, Adnan E, Haryadi RD, Idris I, et al. Changes in levels of cartilage oligomeric proteinase and urinary C-terminal telopeptide of type II collagen in subjects with knee osteoarthritis after dextrose prolotherapy: a randomized controlled trial. J Rehabil Med 2021; 53: jrm00196.","DOI":"10.2340\/16501977-2835"},{"key":"28320","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.2340\/16501977-2835","DOI":"10.2340\/16501977-2835"},{"key":"28321","doi-asserted-by":"crossref","unstructured":"Hosseini B, Taheri M, Ardekani RP, Moradi S, Mofrad MK. Periarticular hypertonic dextrose vs intraarticular hyaluronic acid injections: a comparison of two minimally invasive techniques in the treatment of symptomatic knee osteoarthritis. Open Access Rheumatol Res Rev 2019; 11: 269-274.","DOI":"10.2147\/OARRR.S215576"},{"key":"28322","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.2147\/OARRR.S215576","DOI":"10.2147\/OARRR.S215576"},{"key":"28323","doi-asserted-by":"crossref","unstructured":"G\u00fcl D, Ors\u00e7elik A, Akpancar S. Treatment of osteoarthritis secondary to developmental dysplasia of the hip with prolotherapy injection versus a supervised progressive exercise control. Med Sci Monit 2020; 26: 1-8.","DOI":"10.12659\/MSM.919166"},{"key":"28324","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.12659\/MSM.919166","DOI":"10.12659\/MSM.919166"},{"key":"28325","doi-asserted-by":"crossref","unstructured":"Rezasoltani Z, Azizi S, Najafi S, Sanati E, Dadarkhah A, Abdorrazaghi F. Physical therapy, intra-articular dextrose prolotherapy, botulinum neurotoxin, and hyaluronic acid for knee osteoarthritis: randomized clinical trial. Int J Rehabil Res 2020; 43: 219-227.","DOI":"10.1097\/MRR.0000000000000411"},{"key":"28326","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1097\/MRR.0000000000000411","DOI":"10.1097\/MRR.0000000000000411"},{"key":"28327","unstructured":"Rahimzadeh P, Imani F, Faiz SHR, Entezary SR, Nasiri AA, Ziaeefard M. Investigation the efficacy of intra-articular prolotherapy with erythropoietin and dextrose and intra-articular pulsed radiofrequency on pain level reduction and range of motion improvement in primary osteoarthritis of knee. J Res Med Sci 2014; 19: 696-702."},{"key":"28328","doi-asserted-by":"crossref","unstructured":"Reeves KD, Hassanein K. Randomized prospective double-blind placebo-controlled study of dextrose prolotherapy for knee osteoarthritis with or without ACL laxity. 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