X-rays Document Cartilage Regeneration in Knees After Prolotherapy

Ross Hauser, MD & Joseph J. Cukla, LPN. Standard Clinical X-ray Studies Document Cartilage Regeneration in Five Degenerated Knees After Prolotherapy. Journal of Prolotherapy. 2009;1:22-28.


Degenerative Joint Disease is the most common form of arthritis. The condition is marked by progressive destruction of the articular cartilage which is easily documented by standard X-ray studies. The regeneration of this articular cartilage in clinical practice has been difficult. Five knees with articular cartilage degeneration were treated with Prolotherapy in this report. Each of the five knees showed improvement of their standard clinical X-rays after the Prolotherapy, signifying articular cartilage repair with Prolotherapy. It is suggested that before and after X-ray studies can be used to document the response of degenerated joints to Prolotherapy.


Osteoarthritis (OA) is one of the major problems affecting our aging population. It has been estimated that two to three percent of the adult American population suffers from regular pain from OA, and approximately one-third of adults in the US between the ages of 25-74 have radiological evidence of OA in at least one of the major joints.1 Autopsy specimens have demonstrated a 90% prevalence of articular cartilage degenerative changes in weight bearing joints in individuals older than 40 years old.2 The knee is the most symptomatic joint affecting 6.1% of all adults over the age of 30 but rising to 16% of adults over the age of 45.3, 4, 5 Because there is no currently accepted method to stop or reverse joint degeneration, the incidence of symptomatic OA increases by about 1% each year.6

Osteoarthritis is the most common form of knee arthritis and can involve any or all three compartments in the knee: the medial compartment (medial tibial plateau and medial femoral condyle); the lateral compartment (lateral tibial plateau and lateral femoral condyle); or the patellofemoral compartment (patella and femoral trochlear notch).

The increasing number of joint complaints and radiological OA is matched by the rising number of major joint replacements. In one state alone the total number of total knee replacements increased by 81.5% from 1990 to 2000, with a subsequent rise in costs for these procedures of over 200%.7 It is estimated that in the US, the total number of joint replacement surgeries of the hip and knee will increase from 684,000 cases in 2003 to over a million by 2013.8

The current conservative treatments for OA including medications, exercise, Physical therapy, corticosteroid injections, weight control, Synvisc and Hyalgan injections, and operative treatments including arthroscopic often leave people with residual pain.9-12 Because of this, many people with OA are seeking alternative treatments including Prolotherapy.13-14

Prolotherapy, also known as regenerative injection therapy, involves the injection of substances into degenerated or injured areas to stimulate healing.15-17 While it has been traditionally used for ligament and tendon injuries, it has a long history of use in OA.18-20 Two placebo-controlled double-blind studies by K. Dean Reeves and associates have demonstrated beneficial effects of Prolotherapy on OA including some X-ray changes.21-22

This report documents the results in five degenerated knees treated with Prolotherapy. Before and after X-rays were available to document articular cartilage regeneration with Prolotherapy.

Read the full article at the Journal of Prolotherapy.

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