***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background : Knee osteoarthritis ( KOA ) is a common disabling disease . Limited studies have demonstrated that prolotherapy with dextrose or with prolozone can be helpful in the treatment of patients with KOA . Objectives : In the current study , we compared the results between these two treatment methods . Patients and Methods : In the current r and omized clinical trial , 80 patients with mild to moderate KOA were r and omly assigned equally into two groups ( ozone group and dextrose group ) . In each group , injections were repeated three times with 10-day intervals . Before the treatment and 3 months after the injections , the pain intensity was measured by using a visual analogue scale and the Western Ontario and McMaster university arthritis index scores . Finally , the results were compared between the two groups . Results : In the two groups , the pain intensity and WOMAC scores significantly decreased and increased , respectively ( P < 0.001 ) . However , there was no significant difference between the two groups . Conclusions : Prolotherapy with dextrose and with prolozone result in the same pain relief or functional improvement in patients with mild to moderate KOA Introduction Osteoarthritis ( OA ) is a chronic joint disease that usually occurs in older people and leads to pain and disabilities . OA treatment ranges from drug therapy to surgery . Drug and rehabilitation therapy are preferred over surgery , and , especially , there is a tendency toward compounds causing regenerative changes in the knee joint . In the present study , the effects of platelet-rich plasma ( PRP ) injection and prolotherapy ( PRL ) were examined on the level of pain and function of the knee joint in patients with OA . Methodology After fulfilling the inclusion criteria and signing the informed consent form , 42 patients with knee OA were scheduled for intra-articular injection in the present r and omized , double-blind , clinical trial . Following admission to the operating pain room , the condition of the patient ’s knee was evaluated first via the Western Ontario and McMaster Universities Osteoarthritis Index ( WOMAC ) and , then , ultrasound-guided knee injection was done . Accordingly , patients in the PRP therapy group received 7 mL PRP solution and those in the PRL group received 7 mL 25 % dextrose . Using the WOMAC , levels of pain and knee function were evaluated and recorded for each patient immediately prior to the first injection as well as at 1 month ( immediately prior to the second injection ) , 2 months ( a month after the second injection ) , and 6 months later . Data collected were analyzed using the SPSS v.20 . Results During the first and second months , a rapid decrease in the overall WOMAC score was observed in both groups . The overall WOMAC score increased at the sixth month , but was lower than the overall WOMAC score in the first month . Statistical analysis indicated that the overall WOMAC score significantly decreased in both groups of patients over 6 months . Conclusion Results of the present study suggested a significant decrease in the overall WOMAC score of patients who undergo either PRP therapy or PRL . This positive change in the overall WOMAC score led to an improvement in the quality of life of patients with knee OA shortly after the first injection . PRP injection is more effective than PRL in the treatment of knee OA Purpose This study was performed to compare the efficacy of treatment in three groups of patients with knee osteoarthritis ( OA ) given an intra-articular injection of platelet-rich plasma ( PRP ) , hyaluronic acid ( HA ) or ozone gas . Methods A total of 102 patients with mild – moderate and moderate knee OA who presented at the polyclinic with at least a 1-year history of knee pain and VAS score ≥4 were r and omly separated into three groups . Group 1 ( PRP group ) received intra-articular injection of PRP × 2 doses , Group 2 ( HA group ) received a single dose of HA , and Group 3 ( Ozone group ) received ozone × four doses . Weight-bearing anteroposterior – lateral and Merchant ’s radiographs of both knees were evaluated . WOMAC and VAS scores were applied to all patients on first presentation and at 1 , 3 , 6 and 12 months . Results At the end of the 1st month after injection , significant improvements were seen in all groups . In the 3rd month , the improvements in WOMAC and VAS scores were similar in Groups 1 and 2 , while those in Group 3 were lower ( p < 0.001 ) . At the 6th month , while the clinical efficacies  of PRP and HA were similar and continued , the clinical effect of ozone had disappeared ( p < 0.001 ) . At the end of the 12th month , PRP was determined to be both statistically and clinical ly superior to HA ( p < 0.001 ) . Conclusion In the treatment of mild – moderate knee OA , PRP was more successful than HA and ozone injections , as the application alone was sufficient to provide at least 12 months of pain-free daily living activities . Level of evidence Therapeutic study , Level Background Osteoarthritis is a common degenerative disease . Prolotherapy is an alternative therapy used in multiple musculoskeletal disorders . Objective To compare the effectiveness of intra-articular dextrose injection versus peri-articular prolotherapy in patients with knee osteoarthritis ( KOA ) . Methods Fifty-two adults with painful primary knee osteoarthritis for at least three months were r and omized to intra- and peri-articular injection groups . Prolotherapy was done twice with two week intervals . The outcome measures included the Oxford Knee Scale ( OKS ) , Western Ontario McMaster University Osteoarthritis Index ( WOMAC ) , and Visual Analogue Scale ( VAS ) , which were obtained from patients before the first injection at the base line and after the second injection at the fourth and eighth weeks . Results There were no statistically significant differences between demographic characteristics ; before the injection , pain intensity , OKS , and WOMAC scores were approximately equal between the two groups . After dextrose prolotherapy  , VAS , OKS , and WOMAC scores improved from baseline through the fourth and eighth weeks in both groups without any superiority between the two methods of injections ( p<0.001 ) . Conclusion Dextrose prolotherapy either intra- or peri-articular injection result ed in significant improvement , so it could be an inexpensive and effective management of knee osteoarthritis . Trial registration The study protocol was registered as a clinical trial under registration ID of I RCT 2016091229795N1 at the Iranian Registry of Clinical Trials ( http://www.i rct .ir ) . Funding The authors received no financial support for the research , authors hip , or publication of this article CONTEXT Use of dextrose prolotherapy . Prolotherapy is defined as injection that causes growth of normal cells or tissue . OBJECTIVE Determine the 1 and 3 year efficacy of dextrose injection prolotherapy on anterior cruciate ligament ( ACL ) laxity . After year 1 , determine patient tolerance of a stronger dextrose concentration ( 25 % versus 10 % ) . DESIGN Prospect i ve consecutive patient trial . SETTING Outpatient physical medicine clinic . PATIENTS OR OTHER PARTICIPANTS Eighteen patients with 6 months or more of knee pain plus ACL knee laxity . This laxity was defined by a KT1000 anterior displacement difference ( ADD ) of 2 mm or more . INTERVENTION Intraarticular injection of 6 - 9 cc of 10 % dextrose at months 0 , 2 , 4 , 6 , and 10 . Injection with 6 cc of 25 % dextrose at 12 months . Then , depending on patient preference , injection of either 10 % or 25 % dextrose every 2 - 4 months ( based on patient preference ) through 36 months . MAIN OUTCOME MEASURES Visual analogue scale ( VAS ) for pain at rest , pain on level surfaces , pain on stairs , and swelling . Goniometric flexion range of motion , and KT1000-measured ADD were also measured . All measurements were obtained at 0 , 6 , 12 and 36 months . RESULTS Two patients did not reach 6 month data collection , 1 of whom was diagnosed with disseminated cancer . The second was wheelchair-bound and found long-distance travel to the clinic problematic . Sixteen subjects were available for data analysis .  KT1000 ADD , measurement indicated that 6 knees measured as normal ( not loose ) after 6 months , 9 measured as normal after 1 year ( 6 injections ) , and 10 measured as normal at 3 years . At the 3 year follow-up , pain at rest , pain with walking , and pain with stair use had improved by 45 % , 43 % , and 35 % respectively . Individual paired t tests indicated subjective swelling improved 63 % ( P = .017 ) , flexion range of motion improved by 10.5 degrees ( P = .002 ) , and KT1000 ADD improved by 71 % ( P = .002 ) . Eleven out of 16 patients preferred 10 % dextrose injection . CONCLUSION In patients with symptomatic anterior cruciate ligament laxity , intermittent dextrose injection result ed in clinical ly and statistically significant improvement in ACL laxity , pain , swelling , and knee range of motion Background : Osteoarthritis is one of the most common diseases and the knee is the most commonly affected joint . Intra-articular prolotherapy is being utilized in acute and chronic pain management setting . This study was design ed to compare the efficacy of three methods of intra-articular knee joint therapies with erythropoietin , dextrose , and pulsed radiofrequency . Material s and Methods : After approval by the Ethics Committee and explaining the therapeutic method to volunteers , 70 patients who were suffering from primary knee osteoarthrosis went through one of the treatment methods ( erythropoietin , dextrose , and pulsed radiofrequency ) . The study was double-blind r and omized clinical trial performed from December 2012 to July 2013 . Patients ’ pain level was assessed through the visual analog pain scale ( VAS ) , and range of motion ( ROM ) was measured by goniometric method . Furthermore , patients ’ satisfaction was assessed before and after different treatment methods in weeks 2 , 4 , and 12 . For analysis , Chi-square , one-way ANOVA , and repeated measured ANOVA were utilized . Results : The demographic results among the three groups did not indicate any statistical difference . The mean VAS in erythropoietin group in the 2nd , 4th , and 12th weeks was 3.15 ± 1.08 , 3.15 ± 1.08 , and 3.5 ± 1.23 , respectively ( P ≤ 0.005 ) . Knee joint ROM in the erythropoietin group in the 2nd , 4th , and 12th weeks was 124 ± 1.50 , 124 ± 1.4 , and 123 ± 1.53 respectively ( P ≤ 0.005 ) . Satisfaction score in the 12th week in erythropoietin group was extremely satisfied 15 % , satisfied 55 % , and moderately satisfied 30 % , ( P = 0.005 ) . No specific side-effects were observed . Conclusion : Intra-articular prolotherapy with erythropoietin was more effective in terms of pain level reduction and ROM improvement compared with dextrose and pulsed radiofrequency Background Osteoarthritis ( OA ) is a degenerative disease that can lead to painful and dysfunctional joints . Prolotherapy involves using injections to produce functional restoration of the soft tissues of the joint . Intra-articular injections are controversial because of the introduction of needles into the articular capsule . Objectives To compare the effect of periarticular versus intra-articular prolotherapy on pain and disability in patients with knee OA . Study design R and omized double-blind controlled clinical trial . Setting Single center , university hospital ( Imam Hossein Hospital , Tehran , Iran ) . Methods A total of 104 patients with chronic knee OA were enrolled . In the intra-articular group , 8 mL of 10 % dextrose and 2 mL of 2 % lidocaine were injected . Injections were repeated at 1 and 2 weeks after the first injection . In the periarticular group , 5 mL of 20 % dextrose and 5 mL of 1 % lidocaine were injected subcutaneously at 4 points in the periarticular area . Pain and disability , as assessed using the Western Ontario and McMaster Universities Osteoarthritis Index ( WOMAC ) , were recorded at each follow-up visit at 1 , 2 , 3 , 4 , and 5 months post-injection . Results The visual analog scale score was significantly lower in the periarticular compared with the intra-articular group at the 2- , 3- , 4- , and 5-month visits but not at 1 month . Morning stiffness and difficulty in rising from sitting were improved in both groups and were not signifi-cantly different in the peri- and intra-articular groups . Pain , joint locking , and limitation scores were all improved in both groups . Difficulty in walking on flat surfaces or climbing stairs , and sitting and st and ing pain , were all improved in both groups from 1 to 5 months after treatment . Limitations WOMAC scores are subjective and could be a limitation of the study . Conclusion Periarticular prolotherapy has comparable effects on pain and disability due to knee OA to intra-articular injections , while avoiding risks of complications Objectives : Prolotherapy is an injection-based complementary treatment , which has shown promising results in the treatment of different musculoskeletal disorders . The aim of this study was to determine the 
    Output:
    
Conclusions In terms of pain reduction and function improvement , prolotherapy with hypertonic dextrose was more effective than infiltrations with local anesthetics , as effective as infiltrations with hyaluronic acid , ozone or radiofrequency and less effective than PRP and erythropoietin , with beneficial effect in the short , medium and long term .
In addition , no side effects or serious adverse reactions were reported in patients treated with hypertonic dextrose .