A growing body of clinical trials has explored whether dextrose prolotherapy can meaningfully help people living with knee osteoarthritis. Across 11 randomized studies, a clear pattern emerges: injecting dextrose directly into the joint consistently reduces pain and improves function when compared with saline or exercise-based programs, and these benefits appear across multiple follow-up points. PRP may offer a slight advantage over dextrose, although most comparisons don’t reach statistical significance and the evidence quality remains low. Importantly, safety data across trials show no dextrose-related harms, reinforcing its favorable risk profile. As interest in nonsurgical options grows, better-designed, larger RCTs are still needed to clarify how dextrose stacks up against other injectables and to confirm the durability of its effects.