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J Family Med Prim Care. 2025 Jun;14(6):2180-2186.
doi: 10.4103/jfmpc.jfmpc_1206_24. Epub 2025 Jun 30.

The comparative effects of injecting intra-articular platelet-rich plasma and hypertonic dextrose prolotherapy in osteoarthritis knee - A randomized control trial​


Abstract​

Introduction: Knee osteoarthritis is an age-dependent disease caused by degenerative and healing processes in subchondral tissue of articular and bone cartilage, resulting in changes of its biochemical properties that eventually causes pain, stiffness, and decreased articular function. Therefore, this study aims to compare the effectiveness of platlet-rich plasma (PRP) therapy and 25% hypertonic dextrose (Dextrose) prolotherapy in patients with knee osteoarthritis.

Material and methods: Single-blind randomized control trial was conducted for 18 months. Patients satisfying the inclusion and exclusion criteria were enrolled from the indoor/outdoor facility of the Department of Physical Medicine and Rehabilitation, King George's Medical University (KGMU), Lucknow, India. The informed consent form was duly signed by all the enrolled patients, who were randomly assigned into two groups by the computer-generated system, A total of 85 study participants in this group I (43 patients) received 5 ml Platelet-Rich Plasma (PRP) and Group II (42 patients) received 5 ml of 25% hypertonic dextrose prolotherapy (Dextrose). To compare the effect in terms of reduction of pain, according to the Numeric pain rating scale (NPRS) and Pain/Discomfort, Walking and Activities of Daily Living (ADL) according to the Lequesne Knee Index (LKI) and assessment of each patient was done at specified period, i.e., 0 weeks (Baseline means immediately before intervention), and 6 weeks after the intervention.

Result: Overall, the baseline to 6 weeks change of LKI-Pain in group I (PRP) was significantly more than the group II (DEXTROSE) (P < 0.001). On considering the parameter of LKI-Pain at baseline and 6 weeks for PRP and Dextrose, it was found that in Group I, the mean ± SD reduced more at 6 weeks from 4.81 ± 1.55 to 2.44 ± 1.76 as compared to participants in Group II with 4.83 ± 1.17 at baseline to 6 weeks 3.64 ± 0.98, LKI-Activities of Daily Living (ADL) for group I PRP the Mean ± SD score dropped more from 4.66 ± 1.40 to 2.95 ± 1.35 whereas for group II Dextrose the Mean ± SD score dropped from 4.68 ± 1.40 to 3.65 ± 1.51 at baseline and 6 week respectively and At baseline, the mean LKI-Total score in group I was 12.85 ± 3.59 while in group II the mean score was 13.11 ± 3.15. At 6 weeks, the mean LKI-Total score in group I was 7.63 ± 3.85; in group II the mean score was 10.11 ± 2.93. A significant difference was found in the mean LKI-Total score between the groups at 6 weeks (P = 0.001) and found to be lesser in group I.

Conclusion: It could thus be concluded that on considering the effect of platelet-rich plasma and 25% hypertonic dextrose prolotherapy in patients with knee osteoarthritis, significant improvement was seen in participants administered with both platelet-rich plasma and dextrose with the higher effect being with platelet-rich plasma.

Keywords: Knee osteoarthritis; platelet-rich plasma (PRP); prolotherapy.

Copyright: © 2025 Journal of Family Medicine and Primary Care.

PubMed Disclaimer
 
only 6 weeks duration.

not blinded - looks like people knew what they were getting.

small group size.

did not see report of complications. maybe there were none.



so take home conclusion: dextrose injections can help. 🙂
 
Eur Radiol. 2025 Jul 26.
doi: 10.1007/s00330-025-11867-9. Online ahead of print.

Shear wave elastography to assess healing in lateral epicondylosis: randomized controlled trial with platelet-rich plasma​


Abstract​

Objective: To compare ultrasound and shear wave elastography (SWE) changes in the common extensor tendon over time after platelet-rich plasma (PRP) or corticosteroid (CS) treatment, and to assess for correlations between patient-reported outcomes (PROs) and US/SWE changes of the common extensor tendon.

Materials and methods: A secondary analysis of a prospective double-blinded, randomized controlled trial comparing US and SWE changes after a single treatment of PRP or CS for the treatment of lateral epicondylosis was conducted. Subjects 18-65 years with recalcitrant lateral elbow pain were enrolled between 3/1/2017 and 4/1/2019 and randomized to a treatment group. US/SWE of the common extensor tendon was performed at baseline, 26 weeks, and 52 weeks, and PROs were also recorded. Treatment effects between groups were compared using linear mixed effects models.

Results: Fifty elbows in 47 subjects (mean 48 years ± 8; 25 women) were randomized to two groups-PRP (N = 26) and CS (N = 24). Shear wave speed (SWS) increased with PRP more than with CS at both 26 weeks (2.02 m/s ± 0.61; p = 0.002) and 52 weeks (2.98 m/s ± 0.49; p < 0.01). At 26 weeks, no differences were detected between treatments by conventional US. At 52 weeks, echogenicity and hyperemia improved with PRP relative to CS (p < 0.05). Increased SWS correlated with improvement in all PROs (p < 0.05). For conventional US changes, the only correlation to PROs was that of echogenicity with pain (p = 0.04).

Conclusion: SWS increased more with PRP than CS at 26- and 52-week post-treatment for lateral epicondylosis, and increased SWS correlated with clinical improvement.

Key points: Question Can SWE detect healing changes in the common extensor tendon associated with clinical improvement of lateral epicondylitis in patients treated with PRP or CS injection? Findings Higher common extensor tendon SWSs were associated with clinical improvement and improved more in those treated with PRP than with CS. Clinical relevance statement SWE may be able to quantitatively detect treatment changes in tendons associated with clinical improvement.

Keywords: Elbow tendinopathy; Platelet-rich plasma; Sonoelastography (ultrasonography); Tennis elbow.
 
secondary analysis, extended data.

no control group.

as noted with most studies involving lateral epicondylitis, PRP seems superior to CS when time frames are >3 months.


i havent done a CS injection for lateral epicondylitis in at least 3+ years.
 
lobelsteve said:
Click to expand...

I found their 60 second patient screening quiz.

Gemini_Generated_Image_9vcmfq9vcmfq9vcm.png
 
TIme for Regen Fellowships?

Analysis & Perspective

Call for a Translational Orthobiologics Fellowship in the Era of Regenerative Medicine​

Strader, Shannon DO, MS1; Villaseñor, Andrew DO, MS2; Wyles, Saranya MD, PhD3; Chandan, Priya MD, PhD4; Terzic, Carmen MD, PhD5; Bean, Allison C. MD, PhD6; Master, Zubin PhD7

Author Information
American Journal of Physical Medicine & Rehabilitation 104(9)😛 831-837, September 2025. | DOI: 10.1097/PHM.0000000000002782
AbstractPlain Language Summary
Regenerative medicine is a rapidly advancing field, particularly within the field of physical medicine and rehabilitation. While orthobiologics are currently being used in clinical practice, there remains a need for high-quality clinical trials and translational research to standardize treatments and improve patient outcomes. Education is vital for streamlining development of evidence-based, practical, and effective treatments. In this article, we highlight the need for a 1-yr advanced fellowship in translational orthobiologics aiming to create a standardized core curriculum targeting physicians involved in treating musculoskeletal diseases. The fellowship’s objectives include advancing translational orthobiologics research, ethical considerations, and promoting effective communication regarding orthobiologic therapies. Such a program would serve as a foundation for physicians interested in conducting clinically oriented orthobiologics research for musculoskeletal disorders while improving the development of safe and effective therapeutics related to musculoskeletal disorders.
 
drusso said:
Ignorant.
Click to expand...
yeah right?

make a fellowship to gouge money by using fellows for cheap labor and do research.


then decide that only fellowship trained docs can do regenerative medicine.


then eventually decide that fellowship trained physicians need to take a board exam and recertify every 10 years that rake in oodles more money.



try this instead - have fellowships train regenerative medicine so that all fellowship trained pain docs get trained in them.
 
Even if there was a fellowship there will be naturopaths and APPs that still do them because they've been "trained"
 
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