Efficacy of 5% dextrose prolotherapy compared with saline injections for chondromalacia patella: A randomized controlled trial

OBJECTIVE: To investigate the efficacy of 5% dextrose prolotherapy applied to patients with chondromalacia patella. DESIGN: This 2-arm, double-blinded, prospective, randomized controlled interventional study in a single center included 54 patients with knee pain ongoing for at least 3 months. The patients were randomly assigned to a dextrose prolotherapy group (DPG) or a saline group (SG). Periarticular 5% dextrose prolotherapy or saline injections were applied to these groups, respectively, at 0, 3, and 6 weeks. The outcome measures were Visual Analog Scale (VAS), Patellofemoral Pain Severity Scale (PPSS), Kujala Patellofemoral Scoring System (KPSS), and the Short Form-36 (SF-36) at baseline and at the end of the 3rd, 6th, and 24th weeks. RESULTS: A total of 54 patients were included, with 27 in each group. After the withdrawal of 2, evaluation was made of 52 patients. Compared to baseline values, the VAS, PPSS scores, and number of tender points significantly decreased (p < .001 for all), and the KPSS and SF-36 scores increased at the end of weeks 3, 6, and 24 in both groups (p = .003 for the SF-36 mental health subscale and p < .001 in all other evaluations). At 24 weeks, in the DPG compared to SG, VAS was 1.67 points lower (95% CI: -2.57 to -7.80; p < .001), PPSS was 15.4 points lower (95% CI: -23.6 to -7.18; p < .001), KPSS was 9.3 points higher (95% CI: 5.3-13.2; p < .001), the number of tender points was 0.79 points lower (95% CI: -1.4 to -0.12; p < .021), and the physical function SF-36 subscale was 7.8 points higher (95% CI: 3.6-12.7; p < .001). CONCLUSION: In patients with chondromalacia patella, 5% dextrose prolotherapy reduced pain and improved symptoms, functional status, and quality of life more effectively than saline injections. Therefore, 5% dextrose prolotherapy can be recommended as an effective treatment option.