Periarticular Dextrose Prolotherapy for Patients with Primary Knee Osteoarthritis: A Case Report and Literature Review

關節周圍葡萄糖增生療法治療原發性膝骨關節炎：病例報告及文獻回顧

10.6315/TJPMR.202112_49(2).0008

何彥柔(Yen-Jou Ho)；陳耀仁(Yao-Jen Chen)；何啟中(Chi-Chung Ho)；曾聖維(Sheng-Wei Zeng)；蔡素如(Su-Ju Tsai)；戴龍偉(Long-Wei Dai)

prolotherapy ； ultrasound ； knee osteoarthritis ； 增生療法（prolotherapy） ； 超音波（ultrasound） ； 膝骨關節炎（knee osteoarthritis）

台灣復健醫學雜誌

49卷2期（2021 / 12 / 01）

213 - 220

英文

Knee osteoarthritis (OA) is a common disease that primarily afflicts older adults. The mainstream management of knee OA involves integrative practice, including patient education, weight reduction, exercise, pharmacological therapy, and non-pharmacological modalities. However, prolotherapy with hypertonic dextrose via either intra-articular or periarticular injection, or a combination of both techniques, has become a strong evidence-based treatment or adjuvant therapy that may be used in addition to conservative management. In the literature, two studies have compared the effects of intra-articular and periarticular prolotherapy for knee OA and reveal comparable effects. In addition, the periarticular approach has fewer side effects and post-injection pain. Therefore, periarticular prolotherapy may be a favored method given the lower complication rate. We reported on a patient suffering from long-term knee OA in whom conservative treatment had failed. On our suggestion, he received prolotherapy with ultrasound- guided hypertonic dextrose injection over ligament-bone insertions of the medial collateral ligament of the knee for six sessions. After the therapy, both his pain and disability index improved.

膝骨關節炎是一種相當常見的疾病，主要受影響的是老年人。而目前針對膝骨關節炎的治療仍舊以綜合療法為主流，包括患者教育、減輕體重、運動訓練，藥物治療及非藥物治療方式。近年來，關節內或關節周圍高濃度葡萄糖增生療法已有強烈證據顯示其療效，也可作為保守治療的輔助療法；或者同時合併兩種方式也可達到很好的治療效果。我們報導的這位個案長期受膝關節炎所苦，接受過保守治療一段時間但是仍成效不彰。根據我們的建議，他接受了高濃度葡萄糖增生療法，我們在超音波導引下將高濃度葡萄糖注射到內側副韌帶的韌帶-骨接合處，總共進行了六個療程。治療後，他的疼痛和殘疾指數均有所改善。在文獻回顧裡，比較了針對膝骨關節炎做關節內與關節周圍增生療法兩種注射方式的效果，結果顯示兩者效果不相上下；而關節周圍注射的額外好處是可以減少副作用與注射後的疼痛感，或許對膝關節炎患者而言是個更佳的選擇。

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