| Résumé : |
Objective
To assess the relation between knee osteoarthritis (KOA)-specific quality of life (QOL) and intra-articular cartilage volume (CV) in participants treated with prolotherapy. KOA is characterized by CV loss and multifactorial pain. Prolotherapy is an injection therapy reported to improve KOA-related QOL to a greater extent than blinded saline injections and at-home exercise, but its mechanism of action is unclear.
Design
Two-arm (prolotherapy, control), partially blinded, controlled trial.
Setting
Outpatient.
Participants
Adults with ≥3 months of symptomatic KOA (N=37).
Interventions
Prolotherapy: 5 monthly injection sessions; Control: blinded saline injections or at-home exercise.
Main Outcome Measures
Primary: KOA-specific QOL scores (baseline, 5, 9, 12, 26, and 52wk; Western Ontario and McMaster University Osteoarthritis Index). Secondary: KOA-specific pain, stiffness, function (Western Ontario McMaster University Osteoarthritis Index subscales), and magnetic resonance imaging–assessed CV (baseline, 52wk).
Results
Knee-specific QOL improvement among prolotherapy participants exceeded that among controls (17.6+3.2 points vs 8.6+5.0 points; P=.05) at 52 weeks. Both groups lost CV over time (P<.05 no between-group differences were noted while prolotherapy participants lost cv at varying rates those who the least had greatest improvement in pain scores. among but not control change and stiffness or function scores correlated each loss was associated with less score>
Conclusions
Prolotherapy resulted in safe, substantial improvement in KOA-specific QOL compared with control over 52 weeks. Among prolotherapy participants, but not controls, magnetic resonance imaging–assessed CV change (CV stability) predicted pain severity score change, suggesting that prolotherapy may have a pain-specific disease-modifying effect. Further research is warranted. |
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