Effectiveness of Platelet Rich Plasma Injection in Comparison with Dextrose Prolotherapy on Improving Pain and Function in Osteoarthritis of Knee: A Randomized Controlled Trial

Background: Osteoarthritis is a common and disabling condition that represents a substantial and increasing health burden with notable implications for the individuals affected, health-care systems, and wider socioeconomic costs. Despite significant advances in science and medicine, there is no cure for osteoarthritis. Numerous treatment options have been used for management of osteoarthritis including pharmacological and invasive techniques. Regenerative therapy like Platelet rich plasma and Prolotherapy are being extensively studied due to their ability to regenerate and repair damaged tissues. Objectives: To evaluate the effectiveness of platelet rich plasma injection in comparison with dextrose prolotherapy on improving pain and function in patients with osteoarthritis of the knee. Study Design: Randomized controlled trial Methods: A single blind randomized controlled clinical trial was carried out in the Department of Sports Medicine, Regional Institute of Medical Sciences, Imphal between September 2022 to February 2024. A total of 92 patients were recruited and block of four randomization was done for allotment of the study participants. The outcome measures were visual analog scale (VAS) and Western Ontario Mac Master Osteoarthritis Index (WOMAC) score. For descriptive statistics mean, standard deviation and frequency were used. Student’s t-test and Chi square tests were used for analysis of different variables. A p-value <0.05 was taken as significant. Results: The 2 groups were homogeneous in terms of baseline characteristics like age, sex, side of affection and duration of symptoms (Table 1). The outcome variables of VAS and WOMAC score at baseline were not significant (Table 2). The mean age of the participants was 63.18 ± 5.15 in years. The mean duration of symptoms was 10.16 ± 1.22 in months. Between the groups comparison at the end of 4 weeks showed that there was no statistically significant reduction in the mean difference of outcome measures from baseline. However, at the end of 12 weeks and 24 weeks (p<0.05), there was statistically significant reduction in mean difference of outcome measures from baseline in both the groups but this was more in the Platelet rich plasma group. Conclusion: Platelet rich plasma injection was more effective in comparison to dextrose prolotherapy injections on improving pain and function in patients with osteoarthritis of knee at 24 weeks. Keywords: Osteoarthritis; Knee; platelet-rich plasma; prolotherapy;