RCT
ACE Report #10138

AAOS2018: No difference between prolotherapy and sham saline in Osgood-Schlatter treatment


Study Type:Randomized Trial
OE Level Evidence:N/A
Journal Level of Evidence:N/A

Ultrasonographic Guidance Prolotherapy for Osgood-Schlatter Disease: A Prospective Randomized Double-Blind Study

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This ACE Report is a summary of a conference presentation or abstract. The information provided has limited the ability to provide an accurate assessment of the risk of bias or the overall quality. Please interpret the results with caution as trials may be in progress and select results may have been presented.

Synopsis

38 adolescents with 50 knees affected by Osgood-Schlatter disease were randomized to three monthly treatments of either prolotherapy with a dextrose solution, or so sham prolotherapy with saline. Patients were assessed for function on the Victorian Institute of Sport Assessment (VISA) score after 1, 2 and 3 months. Results demonstrated no significant differences between groups at 1, 2, or 3 months, with a significant increase in scores from baseline for both groups.

Why was this study needed now?

Osgood-Schlatter disease involves pain and swelling over the tibial tubercle in adolescents, particularly among those involved in sporting activities. Prolotherapy has been investigated for efficacy in various musculoskeletal ailments, though not in the setting of Osgood-Schlatter disease.

What was the principal research question?

In the treatment of adolescents with Osgood-Schlatter disease, how does efficacy and safety of prolotherapy with dextrose compare to sham prolotherapy with saline, assessed over 3 months of treatment?

Study Characteristics -
Population:
A total of 50 knees in 38 adolescents with Osgood-Schlatter disease, and previously failed conservative management with physiotherapy and pharmacotherapy.
Intervention:
Prolotherapy group: Patients were allocated to monthly sessions of ultrasound-guided prolotherapy for 3 months. Prolotherapy was completed using a solution of 1mL 20% dextrose and 1mL 1% lidocaine. (n=25 knees; Mean age: 12.4+/-0.9).
Comparison:
Saline group: Patients were allocated to monthly sessions of ultrasound-guided sham prolotherapy for 3 months. Therapy was completed using a solution of 1mL saline and 1mL 1% lidocaine. (n=24 knees; Mean age: 12.4+/-1.2)
Outcomes:
Outcome was the Victorian Institute of Sport Assessment (VISA) score.
Methods:
RCT
Time:
Patients were assessed at 1 month, 2 months, and 3 months after the first injection.

What were the important findings?

  • VISA scores did not significantly differ between the prolotherapy group and the sham group at either 1 month (76.9+/-20.4 vs. 72.6+/-22.2; p=0.508), 2 months (73.3+/-26.8 vs. 74.6+/-26.7; p=0.874), or 3 months (85.7+/-18.7 vs. 83.2+/-19.8; p=0.658).
  • The degree of improvement from baseline after 1 month, 2 months, and 3 months was significant in each group.

What should I remember most?

In the treatment of adolescents with Osgood-Schlatter disease, prolotherapy for 3 months with a dextrose solution demonstrated no significant difference in functional outcome when compared to sham prolotherapy.

How will this affect the care of my patients?

The results of this study suggest that prolotherapy with a dextrose solution may demonstrate no clinical advantage over saline for functional improvement in the management of adolescents with Osgood-Schlatter disease.

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