Table 2.

Summary of the preparations and injection details of prolotherapy in the retrieved trials

Study	Total number of injection doses	Volume per dose	Interval of injection	Regimen	Comparison	Injection technique	Pain measurement extracted for analysis
Randomized controlled trial
Reeves and Hassanein8	3 (3 basic doses but additional injections were allowed in the open-label period)	0.25–0.5 mL at each injection site	2 months	10% dextrose and 0.075% lidocaine in bacteriostatic water	0.075% lidocaine in bacteriostatic water	A 27-gauge needle was inserted at the joint line of all symptomatic DIP, PIP, and thumb CMC joints laterally and medially until firm resistance was felt	Pain during walking
Reeves and Hassanein7	3 (3 basic doses but additional injections were allowed at 6, 8, and 10 months)	9 mL	2 months	10% dextrose and 0.075% lidocaine in bacteriostatic water	0.075% lidocaine in bacteriostatic water	A 27-gauge needle through an inferomedial approach to inject the tibiofemoral joint	Pain during movement
Dumais et al26	4	Intra-articular: 5 mL; extra-articular: 1 mL at each of 8 sites in the collateral ligaments	4 weeks	Intra-articular: 20% dextrose and 0.5% lidocaine; extra-articular: 15% dextrose and 0.6% lidocaine	One group receiving injections on weeks 0, 4, 8, and 12; the other group receiving injections on weeks 20, 24, 28, and 32. Both receiving 32 weeks of exercise (isometric quadriceps exercises, leg extension exercises with quadriceps roll, straight leg raise, and sitting end-range knee extension), 10 repetitions daily	Intra-articular: anterior approach; extra-articular: the osteotendinous junction of both insertion sites of the collateral ligaments was identified	Pain subscale from WOMAC
Rabago et al24	3 (3 basic doses with 2 additional injections if the physicians thought necessary)	Intra-articular: 6 mL; extra-articular: 0.5 mL at each ligament–bone insertion, up to 22.5 mL	4 weeks	Intra-articular: 25% dextrose (5 mL of 50% dextrose mixed with 5 mL of 1% lidocaine); extra-articular: 15% dextrose (6.75 mL of 50% dextrose mixed with 4.5 mL of 1% lidocaine and 11.25 mL of 0.9% saline)	Control: intra-articular: 5 mL of 0.9% saline with 5 mL of 1% lidocaine; extra-articular: 18 mL of 0.9% saline with 4.5 mL of 1% lidocaine. Exercise: 10 at-home knee exercises, begin with 3 sessions per week, 1 session daily, 10 repetitions per exercise; increase as tolerated to 5 sessions per week, 3 times daily, 15 repetitions per exercise	Intra-articular injection through an inferomedial approach; extra-articular injection: up to 15 subdermal injections and 0.5 mL of 15% solution was injected using a peppering technique with a 25-guage needle at each ligament-bone injection	Pain subscale from WOMAC
Jahangiri et al25	3	1 mL	1 month	0.5 mL of 20% dextrose mixed with 0.5 mL of 2% lidocaine	2 monthly placebo injections of 1 mL of 0.9 % saline, followed by a single dose of 40 mg methylprednisolone acetate (0.5 mL) mixed with 0.5 mL of 2% lidocaine in the 3rd month	A 25-gauge needle was inserted toward the ulnar side of the extensor pollicis brevis and just proximal to the base of the first metacarpal in the snuffbox	Pain during movement
Single-arm prospective study
Rabago et al23	3 (3 basic doses with 2 additional injections if the physicians thought necessary)	Intra-articular: 6 mL; extra-articular: 0.5 mL at each ligament–bone insertion, up to 22.5 mL	4 weeks	Intra-articular: 25% dextrose (5 mL of 50% dextrose, 5 mL of 1% lidocaine); extra-articular: 15% dextrose (6.75 mL of 50% dextrose mixed with 4.5 mL of 1% lidocaine and 11.25 mL of 0.9% saline)	NA	Intra-articular injection through an inferomedial approach; extra-articular injection: up to 15 subdermal injections and 0.5 mL of 15% solution was injected using a peppering technique with a 25-guage needle at each ligament–bone injection	Pain subscale from WOMAC

Abbreviations: DIP, distal interphalangeal; PIP, proximal interphalangeal; CMC, carpometacarpal; WOMAC, Western Ontario and McMaster Universities Arthritis Index; NA, not applicable.