From the Universidad Juárez Autónoma de Tabasco, División Académica Multidisciplinaria de Comalcalco, Comalcalco, Tabasco (PIA-V, CAT-Z); Universidad Juárez Autónoma de Tabasco, División Académica de Ciencias de la Salud, Villahermosa, Tabasco (RGC-A); Subdirección Médica de Clínica, Centro de Rehabilitación Infantil Teletón, Tlalnepantla Estado de México (BGL-R); Hospital Chiapas Nos Une Dr. Gilberto Gómez Maza, Secretaría de Salud de Chiapas, Tuxtla Gutiérrez, Chiapas (MLL-N); Universidad Autónoma de Yucatán, Mérida Yucatán (RA-N); and Universidad Juárez Autónoma de Tabasco, División Académica Multidisciplinaria de Jalpa de Méndez, Jalpa de Méndez, Tabasco, México (TBG-C).
Am J Phys Med Rehabil. 2022 Sep 1;101(9):816-825. doi: 10.1097/PHM.0000000000001918. Epub 2021 Nov 18.
Intra-articular injections with hyaluronic acid are recommended in the treatment of knee osteoarthritis; however, hypertonic dextrose prolotherapy has been reported as effective and safe. The aim was to evaluate the effectiveness of hypertonic dextrose prolotherapy for pain reduction and improvement of function in individuals with knee osteoarthritis in comparison with hyaluronic acid by meta-analysis. The search was performed in electronic databases. Six studies were included (395 participants). No statistically significant differences were found between prolotherapy and hyaluronic acid in pain control in the short-term; however, in the subanalysis that included only the studies that used intra-articular injection within the prolotherapy scheme, an effect was found in favor of the prolotherapy groups ( d = -1.33; 95% confidence interval, -2.50 to -0.16; P ( z ) = 0.03). Also, an effect was found in favor of the prolotherapy group in the improvement in function ( d = -1.05; 95% confidence interval, -2.03 to -0.08; P ( z ) = 0.03). No major adverse reactions or side effects were reported in any of the studies. Hypertonic dextrose prolotherapy seems to be an effective intervention to decrease pain and improve function in knee osteoarthritis, with efficacy similar to intra-articular injections with hyaluronic acid in the short-term follow-up. Nonetheless, better-quality clinical trials are necessary.
关节内注射透明质酸被推荐用于治疗膝骨关节炎；然而，高渗葡萄糖普鲁卡因疗法已被报道为有效且安全。本研究旨在通过荟萃分析评估高渗葡萄糖普鲁卡因疗法在减轻疼痛和改善膝骨关节炎患者功能方面与透明质酸相比的有效性。检索了电子数据库。共纳入 6 项研究（395 名参与者）。在短期疼痛控制方面，普鲁卡因疗法与透明质酸之间未发现统计学差异；然而，在仅包括普鲁卡因疗法方案中使用关节内注射的研究的亚分析中，发现普鲁卡因疗法组更有效（ d = -1.33；95%置信区间，-2.50 至 -0.16；P ( z ) = 0.03）。此外，普鲁卡因疗法组在改善功能方面也更有效（ d = -1.05；95%置信区间，-2.03 至 -0.08；P ( z ) = 0.03）。在任何研究中均未报告重大不良反应或副作用。高渗葡萄糖普鲁卡因疗法似乎是一种有效的干预措施，可减轻膝骨关节炎的疼痛并改善功能，在短期随访中与关节内注射透明质酸的疗效相当。然而，仍需要进行高质量的临床试验。
