Dextrose Prolotherapy on Articular Cartilage
- Conditions
- Arthritis Knee
- Interventions
- Drug: Dextrose prolotherapy
- Registration Number
- NCT06301958
- Lead Sponsor
- Chang Gung Memorial Hospital
- Brief Summary
Dextrose prolotherapy is a controversial injection therapy in sports medicine. Currently, 25% hypertonic glucose solution is commonly used in clinical practice. Although this method has a certain therapeutic effect, there is still some controversy about the molecular mechanism of dextrose prolotherapy. In the past, it was thought that local stimulation would increase inflammatory reactions such as local leukocyte and macrophage infiltration and restart the "self-healing mechanism." However, some studies have pointed out that this treatment can cause cell apoptosis. In my clinical work, I often perform dextrose prolotherapy. I deeply feel the importance of exploring the detailed mechanism of action of this therapy in order to apply this therapy more appropriately to patients. We believe that the concentration of 25% hypertonic glucose solution should show a stepwise decrease in the joint cavity. Our preliminary cell experiment results using 2-fold serial dilutions of 25% glucose solution showed that 25%, 12% and 6% glucose solution will trigger the apoptosis of chondrocytes, vascular endothelial cells and immune cells, and will also inhibit the expression of the pro-inflammatory factor IL-6. Glucose solution below 3% will not have the effect of inducing apoptosis on cells. We believe that the therapeutic effect of 25% hypertonic glucose solution in the joint cavity may have cell-specific effects as the concentration changes dynamically. Therefore, in this study, we will clarify the therapeutic mechanism of dextrose prolotherapy for arthritis through basic research and clinical specimen analysis. The clinical research part will use clinical synovial fluid specimens to verify the therapeutic mechanism of hypertonic glucose dissolution. The joint pain level assessment of different types of patients (OA and RA) before dextrose prolotherapy (preliminary period), 1 month after treatment (midterm period) and 3 months after treatment (late period) will be collected, and joint effusion will be measured. Further analyze the cell apoptosis and concentration changes of inflammatory response factors in the liquid.
We hope that through this study, we will have a clear understanding of the molecular mechanism of dextrose prolotherapy on joint component cells. This result will have reference value for the more appropriate application of dextrose prolotherapy in the treatment of human cartilage-related lesions.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 60
- Willing to sign a written consent form
- Adult men and women with arthritis
- Pregnant or lactating women
- Septic arthritis
- Those who have undergone joint surgery within 30 days
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description Dextrose prolotherapy Dextrose prolotherapy A subject received a single intra-articular injection of 25% hypertonic glucose solution 10 mL (1:1 of 50% dextrose and normal saline) into one knee with arthritis after aspiration of all synovial fluid.
- Primary Outcome Measures
Name Time Method Visual Analogue Scale (VAS) baseline, 1 month after treatment, and 3 months after treatment Measurement of knee pain
- Secondary Outcome Measures
Name Time Method Western Ontario and McMaster Universities Arthritis Index (WOMAC) baseline, 1 month after treatment, and 3 months after treatment Osteoarthritis Index
Interleukin 6 (IL-6) baseline, 1 month after treatment, and 3 months after treatment An inflammation-related biomarker
Trial Locations
- Locations (1)
Chang Gung Memorial Hospital, Chiayi
🇨🇳Chiayi City, 嘉義市, Taiwan