The Research Question Knee osteoarthritis (OA) is common, debilitating and often refractory to routine care. Prolotherapy, a “regenerative” injection therapy, has been reported to be effective in rigorous randomized controlled trials. The standard injection protocol includes injections inside and around the knee joint, but requires special training, limiting access. Study question: Among adults with knee OA, what is the effect of a brief prolotherapy injection protocol, compared to blinded saline injections, on knee pain as assessed by a validated questionnaire?

Research Design and Method Design: 12-month blinded randomized controlled trial (N=76) Participants: Adults with knee OA. Intervention: Participants were allocated to 4 monthly ntra- articular injections of prolotherapy (hypertonic dextrose) or control (saline). Assessment: Western Ontario McMaster University Osteoarthritis Index (WOMAC) pain sub-scale (0-100 points).

What the Research Found 76 participants High adherence to treatment and questionnaires completion. Dextrose prolotherapy participants reported over 22 points of change on the WOMAC pain scale; control participants reported about 10 points; Difference between groups was statistically and clinically significant at 6 and 12 months. Satisfaction with dextrose prolotherapy was high No adverse events were reported.

What this means for Clinical Practice Prolotherapy using 25% dextrose as the injectant safely reduced pain by clinically relevant margins through 12 months. The procedure, a single intra-articular injection delivered monthly for 4 sessions, is straightforward and routinely taught as part of conventional medical training. These findings suggest that dextrose prolotherapy may be a safe, accessible therapy ready for routine care of knee OA.