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Br Med Bull. 2017 Jun 1;122(1):91-108. doi: 10.1093/bmb/ldx006.

The effectiveness of prolotherapy in treating knee osteoarthritis in adults: a systematic review.

Author information

Good Hope Hospital, Heart of England NHS Foundation Trust, Birmingham, B75 7RR, UK.
Dubai Physiotherapy & Rehabilitation Center, Al Garhoud Private Hospital, Al Garhoud, United Arab Emirates.
Deparment of Orthopaedic Sports Medicine, Dr Humeira Badsha Medical Center, Dubai, United Arab Emirates.
Department of Orthopaedics, Rehabilitation and Podiatry, Ft. Belvoir Community Hospital, Ft. Belvoir, VA, USA.
Department of Musculoskeletal Disorders, University of Salerno School of Medicine and Dentistry, Salerno, Italy.
Queen Mary University of London, Barts and the London School of Medicine and Dentistry Centre for Sports and Exercise Medicine, Mile End Hospital, 275 Bancroft Road, London E1 4DG, England.



Osteoarthritis (OA) often leads to symptoms such as pain, stiffness and decreased function. OA is treated with a wide range of modalities, both conservatively and surgically. Prolotherapy has been used to treat various musculoskeletal problems and has shown some promise.

Sources of data:

Searches of the electronic databases, PubMed, ISI web of science, PEDro and SPORTDiscus, were conducted for all Level 1-4 studies published from inception through to December 2016.

Areas of agreement:

Ten studies were evaluated and results show significant improvement in scores for pain, function and range of motion, both in the short term and long term. Patient satisfaction was also high in these patients (82%).

Areas of controversy:

Meta-analysis was not possible due to heterogeneity of outcome measures and populations.

Growing points:

Moderate evidence suggests that prolotherapy is safe and can help achieve significant symptomatic control in individuals with OA.

Areas for developing research:

Future research should focus on larger sample size, standardization of treatment protocol and basic science evidence.


dextrose; injection; knee; osteoarthritis; proliferative; prolotherapy; regenerative

[Indexed for MEDLINE]

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