Stairs have become a negotiation. Getting up from a chair takes a push. Your knee aches after a walk and stiffens overnight. Maybe you’ve been told it’s “just arthritis,” and your options are to wait for a replacement or keep taking pain relievers.
For people with chronic knee pain, especially knee osteoarthritis, prolotherapy is one of the better-studied injection options.
How prolotherapy works in the knee
Prolotherapy involves injecting a solution into the knee joint and around the ligaments and tendons that stabilize it. The goal is to stimulate the body’s repair response in tissues that heal slowly on their own.
At Venturis Clinic, knee prolotherapy may use dextrose or an oxygen-ozone mixture, depending on your situation.
What the research shows
Knee osteoarthritis has the strongest research support of any prolotherapy use:
- A randomized controlled trial (Rabago et al., Annals of Family Medicine, 2013) compared dextrose prolotherapy with saline injections and with at-home exercise in adults with knee osteoarthritis. The dextrose group reported greater improvement in pain, function, and stiffness scores over one year.
- A systematic review and meta-analysis (Sit et al., Annals of Family Medicine, 2016) found that dextrose prolotherapy improved knee osteoarthritis symptoms compared with control injections.
- Ozone injections for knee osteoarthritis have shown short-term improvement in pain in systematic reviews (Sconza et al., 2020). Long-term data are more limited.
Trials are relatively small, and results vary between people. Prolotherapy doesn’t regrow a joint, and it isn’t a substitute for a knee replacement when one is truly needed.
Who may be a candidate
- Mild to moderate knee osteoarthritis
- Chronic knee pain lasting months despite exercise, weight management, or physical therapy
- Knee ligament laxity or recurring instability
- People who want to explore options before considering surgery
Who may not be a candidate
- Severe, bone-on-bone arthritis with major deformity
- An active infection in or near the knee
- A locked knee, a large mechanical tear, or a suspected fracture, which need orthopedic evaluation
- Certain bleeding disorders or uncontrolled diabetes
What to expect
- Evaluation: a knee exam, your history, and review of any X-rays or MRIs.
- Plan: the approach, the injection sites, and a realistic number of sessions. A series spaced several weeks apart is typical.
- Injection visit: the knee is cleaned and injected, and the visit is usually brief.
- Afterward: soreness, swelling, and stiffness for a few days are common. You’ll get specific activity guidance.
Risks
- Common: post-injection pain, swelling, and stiffness.
- Uncommon: bruising, infection, or allergic reaction.
- Rare with ozone: serious complications if gas enters a blood vessel.
All risks are reviewed before treatment.
When to seek urgent care
Seek care promptly after any knee injection if you have a hot, red, severely swollen knee, fever, or rapidly worsening pain. These can be signs of infection.
Serving Oklahoma City, Tulsa, and all of Oklahoma
Venturis Clinic sees patients from Oklahoma City and surrounding areas, including Tulsa, and from across Oklahoma. Learn more on our Prolotherapy in Oklahoma City page.
Frequently asked questions
Does prolotherapy work for knee arthritis? Clinical trials have found improvements in pain and function for mild to moderate knee osteoarthritis, though individual responses vary.
How many knee prolotherapy sessions are typical? A series of injections spaced several weeks apart is common, and progress is reassessed along the way.
Can prolotherapy help me avoid knee replacement? Some people use it to manage symptoms before considering surgery, but it can’t reverse severe joint damage.
Is prolotherapy better than cortisone for knees? They work differently. Cortisone reduces inflammation short-term; prolotherapy aims to stimulate a healing response.
Ready to talk about your knee? Book a free 15-minute discovery call, or learn more about prolotherapy in Oklahoma City.
Individual results vary. This page is for educational purposes and is not a guarantee of outcome.
By Alvin Philipose, DC, ICCP
Sources
- Rabago D, et al. Dextrose prolotherapy for knee osteoarthritis: a randomized controlled trial. Annals of Family Medicine. 2013;11(3):229–237.
- Sit RWS, et al. Annals of Family Medicine. 2016;14(4):314–322.
- Sconza C, et al. Arthroscopy. 2020;36(1):277–286.