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Abstract Knee osteoarthritis is a progressive musculoskeletal disease that leads to physical impairment and disability. KOA is characterized by structural alteration of the AC, subchondral bone, synovium, ligaments and muscles, leading to shifting in the concept of OA from a AC oriented disease to a whole joint disease. There is no cure for KOA, however, there are several therapeutic options that might be helpful in reducing symptoms but do very little in changing the biochemical environment or the degree of degeneration. Prolotherapy is a therapeutic option used in managing chronic musculoskeletal conditions. Irritant substances, usually hyperosmolar dextrose or morrhuate sodium, are injected either IA or locally at ligamentous and tendinous attachments. Hypertonic solutions are thought to produce an inflammatory response through the recruitment of chemical mediators and growth factors that stimulate local healing of injured extra- and intra-articular tissue. DPT may also stimulate collagen deposition in the ligaments, tendons, and capsule of osteoarthritic joints. Prolotherapy may also decrease transmission in nociceptive pain fibers. Some studies have suggested safety, pain relief, and functional improvements among patients with OA receiving DPT, this warrants for more clinical studies. The current study aimed to investigate the efficacy of DPT in the treatment of symptomatic KOA and to evaluate its potential proliferative role. Moreover, to study the role of high-resolution MSUS in the assessment of knee status before and after the use of DPT. |