Perineural Prolotherapy in Chronic Knee Osteoarthritis Pain: A Randomized Controlled Trial.
The aim of this study is to test whether the addition of dextrose to perineural injections is superior to local anesthetic alone, as some initial data have indicated. To enhance the potential therapeutic effect, we will proceed to a 4-point injection technique, targeting 4 genicular nerves (superomedial, superolateral, inferomedial, recurrent peroneal genicular nerve) in a randomized controlled trial with two arms.
• Patients of both sexes
• Age \>38 years
• Body Mass Index (BMI) up to 42 kg/m2
• Diagnosis of knee osteoarthritis, according to the clinical criteria of the American College of Rheumatology. Osteoarthritis if the following combinations are present:
• A, B, C, D or A, B, E or A, D, E:
• A) Knee pain most days of the previous month B) Cracking during active joint movement C) Morning stiffness lasting at least 30 minutes D) Age at least 38 years E) Bone swelling of the affected knee on physical examination
• Chronic knee pain on the Numerical Rating Scale (NRS) \> 5 for at least 3 months prior to the study
• Grade 2 or 3 osteoarthritis, according to the Kellgern-Lawrence classification
• Pain, creaking, and stiffness in the knee joint that persists for at least three months prior to the study.