CHANGES IN LEVELS OF CARTILAGE OLIGOMERIC PROTEINASE AND URINARY C-TERMINAL TELOPEPTIDE OF TYPE II COLLAGEN IN SUBJECTS WITH KNEE OSTEOARTHRITIS AFTER DEXTROSE PROLOTHERAPY: A RANDOMIZED CONTROLLED TRIAL

Objective: To assess the effects of dextrose prolo & shy; therapy in patients with knee osteoarthritis on the levels of serum cartilage oligomeric proteinase and urinary C & shy;terminal telopeptide of type II collagen, and on the Western Ontario McMaster Universities Index and numerical rating scale score for pain. Methods: A randomized controlled trial, in which participants were randomly allocated into 2 groups, receiving injections of either hyaluronic acid or dex & shy; trose prolotherapy. The hyaluronic acid group receiv & shy; ed 5 injections, 1 each on weeks 1, 2, 3, 4 and 5, and the dextrose prolotherapy group received 3 injec & shy; tions, 1 each on weeks 1, 5 and 9. Serum cartilage oligo meric proteinase, urinary C & shy;terminal telopeptide of type II collagen, Western Ontario McMaster Univer & shy; sities Index score, and numerical rating scale score for pain were measured at baseline and 3 weeks after the last injection. Comparative analysis was conduct & shy; ed using Wilcoxon test within groups and analysis of covariance (ANCOVA) test between groups. Results: A total of 47 participants (21 allocated to hyaluronic acid, 26 allocated to dextrose proloth & shy; erapy) completed the protocol. Both interventions resulted in significant improvements in numerical ra & shy; ting scale scores for pain, total Western Ontario Mc & shy; Master Universities Index scores, and its subscales score. However, the dextrose prolotherapy outperfor & shy; med hyaluronic acid in numerical rating scale score for pain and level of urinary C & shy;terminal telopeptide of type II collagen, with score changes differences of 0.93 (p = 0.042) and 0.34 (p = 0.048), respective & shy; ly. No significant changes in level of serum cartilage oligomeric proteinase were found in either group. Conclusion: Dextrose prolotherapy is an alternative injection therapy for knee osteoarthritis, which was found to be associated with a significant reduction in urinary C & shy;terminal telopeptide of type II collagen compared with hyaluronic acid injection. Neither in & shy; jection method resulted in reduced serum cartilage oligomeric proteinase.