Article

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 (P=.98). While prolotherapy participants
lost CV at varying rates, those who lost the least CV ("stable CV") had the
greatest improvement in pain scores. Among prolotherapy participants, but not
control participants, the change in CV and the change in pain (but not stiffness
or function) scores were correlated; each 1% CV loss was associated with 2.7%
less improvement in pain score (P<.05). 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.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS