Clinical Outcomes of Hypertonic Dextrose Prolotherapy Injection in Obese Patients with Knee Osteoarthritis: A Quasi-Experimental Study

Abstract

Background: Obesity is a major risk factor for knee osteoarthritis (KOA), contributing to pain, reduced joint function, and decreased quality of life. Hypertonic dextrose prolotherapy (HDP) has emerged as a potential treatment to lessen pain and improve function in KOA. This study aimed to observe the clinical outcomes of HDP injections in obese patients with KOA.

Methods: A quasi-experimental study was conducted in 2023, involved obese patients diagnosed with KOA. Participants were divided into two groups: an intervention group receiving HDP injections and a control group receiving normal saline (NS) injections. Clinical outcomes were assessed using the Numeric Rating Scale (NRS) for pain and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) before intervention, and at two and six weeks after intervention. Intergroup and intragroup mean differences were analyzed, with a significance value of p<0.05.

Results: A total of 38 participants were included, with 20 assigned to the HDP group and 18 to the control group. Intragroup analysis showed a significant reduction in NRS scores in both groups (p<0.001), whereas no significant intragroup change was observed in WOMAC scores. Intergroup analysis showed significantly greater improvement in both NRS and WOMAC scores in the HDP group compared with the control group at two and six weeks after intervention (p<0.001).

Conclusions: HDP injections improve clinical outcomes in obese patients with KOA, particularly in reducing pain intensity and improving functional status. Pain reduction may support participation in exercise and weight management programs, although persistent obesity may increase the risk of KOA recurrence.