Table I.

Characteristics of eligible studies

Number	Author, year	Study design	Participant	Sample size	Mean age, years ± SD	Time-points	Intervention		Outcome	Result (Mean ± SD)		Significance
							DPT	Other		Pain	Functional outcome
1	Rabago, et al. (13) 2013	RCT	Adults aged 40–76 years with knee OA. Diagnosis based on ACR criteria	DPT: 30 participants Saline: 29 participants Exercise: 31 participants	Total: 56.7 ± 7.2 DPT: 56.8 ± 7.9 Saline: 56.8 ± 6.7 Exercise: 56.4 ± 7.0	Baseline, 5th week, 9th week, 12th week, 24th week, 52nd week.	Injections were performed 3 times, interval 1 month (additional session 2 times injection) 6 mL 25% dextrose injected intra-articularly. 0.5 mL 15% dextrose injected extra-articularly (at each ligament insertion)	SALINE: Injections performed 3 times, interval 1 month (additional session 2 times injection) 6 mL 0.9% sodium chloride injected intra-articularly 0.5 mL 15% 0.9% sodium chloride injected extra-articularly (at each ligament insertion) EXERCISE: 3 sessions per week, 1 session daily, 10 repetitions per exercise gradually increase therapy as tolerated over 20 weeks (5 sessions per week, 3 times daily, 15 repetitions per exercise) and continue as desired	Pain: pain WOMAC Functional outcome: total WOMAC	Score changes DPT group baseline: 66.8 ± 14.9, week 5: –8.17 ± 19.12; week 9: –14.00 ± 19.28, week 12: –11.78 ± 18.81, week 24: –15.50 ± 18.84, week 52: –14.18 ± 18.46 Saline group baseline: 66.7 ± 16.1, week 5: –3.28 ± 18.85, week 9: –5.29 ± 18.15, week 12: –5.79 ± 17.98, week 24: –6.40 ± 18.15, week 52: –7.38 ± 18.35 Exercise group baseline: 63.2 ± 13.1, week 5: –4.53 ± 18.57,week 9: –3.44 ± 18.45, week 12: –4.89 ± 18.3, week 24: –8.07 ± 18.71, week 52: –9.24 ± 18.51	Score changes DPT group baseline: 63.1 ± 15.0; week 5: –7.94 ± 17.58; week 9: –13.91 ± 17.69; week 12: –13.31 ± 17.25; week 24: –15.85 ± 17.25; week 52: –15.32 ± 16.9) Saline group baseline: 62.7 ± 14.3; week 5: –5.22 ± 17.29; week 9: –6.75 ± 16.67; week 12: –8.19 ± 16.51; week 24: –8.12 ± 16.65; week 52: –7.59 ± 16.8 Exercise group baseline: 60.5 ± 11.3; week 5: –4.42 ± 16.99; week 9: –2.51 ± 16.94; week 12: –4.26 ± 16.8; week 24: –8.48 ± 17.04; week 52: –8.24 ± 16.98	Dextrose outperformed saline (p < 0.05) and exercise (p < 0.05) for pain scale and functional outcome in week 9, week 24, and week 52 Dextrose outperformed exercise (p < 0.05) for pain scale and functional outcome in week 12 There were no other side-effects or adverse events.
2	Hosseini, et al. (14) 2019	RCT	Age 50–75 years with grade II or more knee OA. Diagnosis based on ACR criteria	DPT: 52 participants HA: 52 participants	DPT: 61.2 ± 11.5 HA: 63.7 ± 12.2	Baseline, 12th week.	Injections performed 3 times, interval 1 week 10 mL 12.5% hypertonic dextrose injected extra-articularly through 4 points of injection.	Injections performed 3 times, interval 1 week 2.5 mL hyaluronic acid injected intra-articularly via the inferomedial of patella	Pain: VAS Functional outcome: WOMAC score	Time-point score DPT group Baseline: 7.8 ± 1.4; 12th week: 2.5 ± 1.1 HA group Baseline: 8.2 ± 1.7; 12th week 2.1 ± 0.6	Time-point score DPT group Baseline: 52.7 ± 9.8; 12th week 83.7 ± 12.7; HA group Baseline: 55.9 ± 10.4; 12th week 88.5 ± 15.6	HA outperformed DPT for pain scale (p = 0.02) and total WOMAC (p < 0.001) at week 12 Our results have shown no serious adverse events
3	Jahangiri, et al. (21) 2014	RCT	Age 42–83 years with hand OA. Diagnosis based on clinical evaluation and radiological examination.	DPT: 30 participants LC: 30 participants	Total: 63.6 ± 9.7 DPT: 63.9 ± 9.4 LC: 63.3 ± 10.1	Baseline, 1st month, 2nd months, and 6th months	Injections performed 3 times, interval 1 month. 0.5 mL 20% DPT mixed with 0.5 mL 2% lidocaine injected intra-articularly and extra-articularly	Injections performed 3 times, interval 1 month. First 2 months placebo injectate 1 mL 0.9% saline administered. At third month, 40 mg methylprednisolone acetate (0.5 mL) mixed with 0.5 mL 2% lidocaine injected intra-articularly and extra-articularly	Pain: VAS Functional outcome: total HAQ-DI	Score changes DPT vs HA 0–1st month:– 0.7 ± 3.87; 0–2nd month: 1.0 ± 3.676; 0–6th month: 1.1 ± 3.483	Score changes DPT vs HA 0–1st month: 0.5 ± 2.90; 0–2nd month: 1.0 ± 3.289; 0–6th month: 1.0 ± 3.096	In the 2nd month, the pain score was significantly more with LC (p = 0.02). Hand function improved significantly in the group DPT compared with LC (p = 0.01). After 6 months, pain on movement more significant in the group DPT (p = 0.02). Hand function was significantly better with DPT (0.01). Adverse event info not available
4	Gül, et al. (15) 2020	RCT	Age 18–80 years with secondary hip OA (DDH refractory) who had Crowe Type I–IV lesions	DPT: 20 participants (23 hips) Exercise: 21 participants (23 hips)	DPT: 45.74 ± 16.86 Exercise: 47.56 ± 13.8	Baseline, 21st day, 3rd month, 6th month, 12th month.	Injections were repeat-ed with 21-day intervals. Injection sessions were terminated when the visual analogue scale (VAS) scores decreased to 75% of pre-injection values (maximum 6 times injection) Supine injection points: 8 mL 15% dextrose solution injected extra-articularly insertions. 8 mL 25% dextrose applied intra-articularly Lateral injection points: 12 mL 15% dextrose injected extra-articularly Home exercise: 3 times a day after 3 days of injections	All participants received standard 12-week rehabilitation protocol and supervised progressive resistance training consisting of 30 training sessions Home exercise: 3 times a day after the 12-week rehabilitation programme	Pain: VAS Functional outcome: HHS	Score changes DPT group 0–21 days: – 3.1 ± 1.2; 0–3 months: – 4.0 ± 1.8; 0–6 months: – 4.6 ± 2.6; 0–12 months:– 4.5 ± 2.4. Exercise group 0–21 days: – 1.9 ± 0.9 0–3 months: – 2.6 ± 1.9 0–6 months: 2.8 ± 2.5; 0–12 months: 2.9 ± 2.5	Score changes DPT group 0–21 days: 16.8 ± 7.3; 0–3 months: 19.5 ± 8.9; 0–6 months: 24.2 ± 14.0; 0–12 months: 24.3 ± 13.4. Exercise group 0–21 days: 6.7 ± 6.2; 0–3 months: 19.5 ± 8.9; 0–6 months: 14.8 ± 12.4; 0–12 months: 16.5 ± 11.3	Dextrose injection significantly outperformed the control injection in pain improvement from 0–21 days (p = 0.001), 0–3 months (p = 0.008), 6 months (p = 0.016) and 0–12 months (p = 0.017), in dysfunction improvement from 0–21 days (p < 0.001), 0–3 months (p = 0.006), 6 months (p = 0.007) and 0–12 months (p = 0.018). Adverse event Only 3 participants in the PrT group had severe pain in the injection sites and they took acetaminophen 4 times/day for 5–7 days after injections
5	Rahimzadeh, et al. (3) 2018	RCT	Knee OA	DPT: 21 participants PRP: 21 participants	DPT: 64.3 ± 5.31; PRP: 65.5 ± 6.64	Baseline, 1st month, 2nd months, 6th months	Injections performed 2 times, interval 1 month 7 mL dextrose 25% injected IA by USG guiding	Injections performed 2 times, interval 1 month 7 mL PRP solution injected IA by USG guiding	Pain: pain WOMAC Functional outcome: total WOMAC	Time-point score DPT group Baseline: 14.6 ± 1.4; 1st month: 9.5 ± 2.3; 2nd month: 7.1 ± 1.7; 6th month: 8 ± 1.6. PRP group Baseline: 14.8 ± 1.5; 1st month: 9.2 ± 2.3; 2nd month: 5.4 ± 1.8; 6th month: 6.2 ± 2.1	Time-point score DPT group Baseline: 67.1 ± 7.9; 1st month: 43.8 ± 8.2; 2nd month: 34.8 ± 6.9; 6th month: 38.7 ± 6.6. PRP group Baseline: 67.9 ± 7.3; 1st month: 42.9 ± 10.85; 2nd month: 27.1 ± 9.1; 6th month: 31.4 ± 10.2	Better result in PRP at 2 month and 6 month for functional outcome and pain scale Functional outcome (2,6): (p = 0.004; p = 0.009) Pain (2,6): (p = 0.002; p = 0.003) Adverse effect No significant side-effects were observed
6	Reeves & Hassanein (18) 2000	RCT	Hand OA	DPT: 13 participants NS: 14 participants	DPT: 64.5 ± 9.2 NS: 63.9 ± 9.4	Baseline, 6th month	Injections were performed 3 times, interval 2 months. 0.25–0.5 mL 10% dextrose and 0.075% xylocaine in bacteriostatic Water was injected intra-articularly	Injections were performed 3 times, interval 2 months. 0.25–0.5 mL 0.075% xylocaine in bacteriostatic Water injected intra-articularly	Pain: VAS (movement, rest, grip). Functional outcome: flexion motion (range)	Score changes DPT group rest pain –0.88 ± 1.47; movement pain –1.89 ± 1.40; grip pain –1.8 ± 1.51. NS group rest pain –0.58 ± 1.45; movement pain –0.62 ± 1.38; grip pain –0.92 ± 1.53.	Score changes DPT group Flexion: +8.01 ± 12.83; NS group Flexion: –8.65 ± 10.88	DPT outperformed NS in pain movement (p = 0.027) and functional outcome (p = 0.003) Side-effect information Discomfort after injection lasting a few minutes to several days.
7	Reeves & Hassanein (18) 2000	RCT	Knee OA with or without ACL laxity	25 samples were analysed	63 years	Baseline, 6th month	Injections performed 3 times, interval 2 months 9 cc 10% dextrose and 0.075% lidocaine in bacteriostatic water injected intra-articularly	Injections performed 3 times, interval 2 months 9 cc 075% lidocaine in bacteriostatic water injected intra-articularly	Pain: VAS (pain at rest, walking, stair use) Functional outcome: buckling and flexion range	Score changes DPT group Pain at rest: 0.54 (0.24) Pain with walking: 1.04 (0.25) Pain with stair use: 1.37 (0.31) NS group Pain at rest: 1.04 (0.25) Pain with walking: 0.98 (0.32) Pain with stair use: 1.23 (0.32)	Score changes DPT group Buckling 5.24 (2.23) Flexion range: 13.24 (2.15) NS group Buckling 0.79 (2.27) Flexion range: 7.69 (2.19)	Pain at rest, pain with walking, pain with stair use, swelling, buckling episodes, and flexion range demonstrated a statistically superior effect of active solution (p = 0.015) ADVERSE EVENT Discomfort after injection did not appear. One person (control) had a flare post-injection that appeared substantial, requiring interarticular steroid and then referral to an orthopaedic surgeon. No allergic reactions or infections were noted
8	Rahimzadeh, et al. (17) 2014	RCT	Primary knee OA	Dextrose: 26 participants Erythropoietin: 20 participants, Pulsed radiofrequency: 24 participants	Total: 59.90 ± 8.08 Dextrose: 60.57 ± 7.47 Erythropoietin: 61.15 ± 7.47, Pulsed radiofrequency: 56.95 ± 8.31	Baseline, 2nd week, 4th week, and 12th week	Single-dose injection Intra-articular injection of 5 cc 0.5% ropivacaine together with 5 cc dextrose 25%	Single-dose injection ERYTHROPOIETIN GROUP intra-articular injection of 5 cc ropivacaine 0.5% together with 4,000 international units erythropoietin. PULSED RADIOFREQUENCY GROUP: participants underwent pulsed radiofrequency (20 ms, 2 Hz, 45 V, 15 min, 42°C, 2 cycles) intra-articular	Pain: VAS Functional outcome: ROM	Time-point score DPT group: Baseline: 7.11 ± 1.03 2nd week: 4.50 ± 1.36 4th week: 4.65 ± 1.38 12th week: 5.53 ± 1.60 Erythropoietin group: Baseline: 6.65 ± 0.98 2nd week: 3.15 ± 1.08 4th week: 3.15 ± 0.87 12th week: 3.50 ± 1.23 Pulsed radiofrequency group: Baseline: 7.08 ± 1.41 2nd week: 3.25 ± 2.00 4th week: 3.87 ± 1.70 12th week: 5.50 ± 1.93	Time-point score DPT group: Baseline: 101 ± 1.36 2nd week: 106 ± 1.43 4th week: 110 ± 1.26 12th week: 113 ± 2.16 Erythropoietin group: Baseline: 98.08 ± 1.60 2nd week: 124 ± 1.50 4th week: 124 ± 1.4 12th week: 123 ± 1.53 Pulsed radiofrequency group: Baseline: 95 ± 1.97 2nd week: 105 ± 2.06 4th week: 110 ± 2.11 12th week: 113 ± 2.16	Erythropoietin more efficient than other 2 interventions. DPT outperformed PRF in reducing pain at 2nd week Side-effect: No particular side-effect related to the above-mentioned interventions was observed
9	Hashemi, et al. (9) 2015	RCT	Age 40–75 years with knee OA diagnosed with clinical and radiographic evaluation	DPT: 40 participants OPT: 40 participants	DPT: 57.3 ± 15.1; OPT: 59.1 ± 12.3	Baseline and 3rd month.	Injections repeated 3 times with 7–10 days interval Intra-articular Hypertonic dextrose prolotherapy (12.5% dextrose)	Injections repeated 3 times with 7–10 days interval Intra-articular 15 g/mL ozone-oxygen mixture (5–7 cm3)	Pain: VAS Functional outcome: WOMAC	Time-point score DPT group: Baseline: 8.1 ± 1.1 3rd month: 3 ± 1.2 OPT group: Baseline: 7.6 ± 1.3 3rd month: 2.8 ± 1.1	Time-point score DPT group: Baseline: 58.5 ± 13.3 3rd month: 83.7 ± 15.3 OPT group: Baseline: 56.3 ± 11.5 3rd month: 81.6 ± 13.7	Have same effectiveness (p > 0.05) Side-effect: No available information
10	Waluyo et al. (13) 2021	RCT	Knee OA diagnosed based on ACR criteria	DPT: 26 participants HA: 21 participants	Total: 62.4 ± 8.7 DPT group: 62.6 ± 6.9 HA group: 62.0 ± 10.8	Baseline and 12th week	Injections repeated 3 times with 4 weeks interval 5 mL 25% dextrose injected Intra-articularly and 30–40 mL 15% dextrose injected extra-articularly	Injections repeated 5 times with 1 week interval 2 mL hyaluronic acid intra-articular injection (~10 mg)	Pain: NRS Functional outcome: total WOMAC	Score changes DPT group baseline: 4.85 ± 1.71 12th week: –3.38 ± 2.21 HA group baseline: 3.48 ± 1.53 12th week: –1.62 ± 1.63	Score changes DPT group baseline: 36.08 ± 10.06 12th week: –16.92 ± 13.86 HA group Baseline: 24.81 ± 17.25 12th week: –8.95 ± 9.79	More improvement in DPT group for pain scale. Side-effect: No serious adverse event occurred. All participants experienced expected mild-to moderate post-injection pain within 2–3 days. Only 1 participant, from the prolotherapy group, took paracetamol due to severe pain post-injection.
11	Sert, et al. (11) 2020	RCT	Aged 40–70 years with knee pain refractory to conservative therapy and diagnosed as Grade 2 or 3 KOA according to KL classification	DPT: 21 participants Saline: 22 participants Exercise: 19 participants	DPT: 55.7 ± 6.6 Saline: 54.4 ± 7.3 Exercise: 52.0 ± 6.1	Baseline, 6th week and 18th week	Injections performed 3 times with 3 weeks interval and performed a home-based exercise programme 5 mL 25% dextrose applied intra-articularly 10 mL 15% dextrose solution was applied extra-articularly.	SALINE: Injections performed 3 times with 3 weeks interval and performed a home-based exercise programme 2.5 mL 0.9% sodium chloride +2.5ml 1% lidocaine applied intra-articularly 5 mL 0.9% sodium chloride +5ml 1% lidocaine extra-articularly EXERCISE: Exercise programme was performed for at least 3 days a week and included hamstring and quadriceps stretching, isometric quadriceps strengthening exercises, and terminal knee extension exercises, each comprising 3 sets with 10 repetitions.	Pain: VAS Functional outcome: total WOMAC	Time-point score DPT group baseline: 7.2 ± 1.0; 6-week: 4.1 ± 1.8; 18-week: 1.1 ± 1.9 Saline group baseline: 7.4 ± 2.0; 6-week: 4.9 ± 2.2; 18-week: 4.6 ± 1.8 Exercise group baseline: 7.0 ± 0.9; 6-week: 4.9 ± 2.0; 18-week: 4.5 ± 2.0	Time-point change DPT group baseline: 68.7 ± 11.4; 6-week: 44.4 ± 11.5; 18-week: 32.7 ± 11.6 Saline group baseline: 69.2 ± 17.6; 6-week: 50.5 ± 16.7; 18-week: 46.7 ± 13.5 Exercise group baseline: 68.9 ± 11.9; 6-week: 61.0 ± 10.8; 18-week: 59.8 ± 10.7	The WOMAC and VAS-pain scores significantly decreased at 18 weeks in the DPT compared with the saline (p = 0.002 and p < 0.001, respectively) and exercise (p < 0.001 and p < 0.001, respectively)
12	Sit, et al. (20) 2020	RCT	Age 45–75 years, diagnosis of KOA based on ACR criteria	DPT: 38 participants Saline: 38 participants	Total: 63.2 ± 5.5 DPT: 62.8 ± 5.8 Saline: 63.7 ± 5.2	Baseline, 16th week, 26th week, and 52nd week.	Injections performed 4 times, interval 4 weeks 5 mL 25% dextrose injected intra-articularly by USG guiding	Injections were performed 4 times, interval 4 weeks 5 mL normal saline injected intra-articularly by USG guiding	Pain: VAS Functional outcome: total WOMAC	Pain intensity (VAS)b 16 weeks: –3.70 (–13.83 to 6.43) 26 weeks: –6.73 (–16.86 to 3.40) 52 weeks: –10.98 (–21.36 to –0.61) Overall trend: –7.02 (–14.50 to 0.46)	WOMAC composite b 16 weeks: –4.33 (–12.27 to 3.62) 26 weeks: –7.34 (–15.28 to 0.61) 52 weeks: –9.65 (–17.77 to –1.53) Overall trend: –7.03 (–13.14 to –0.92)	In the study’s primary linear mixed model analysis, all outcomes demonstrated a positive trend favouring the DPT group over the saline group. The composite WOMAC score at 52 weeks showed a difference-in-difference estimate of –9,65 (95% CI, –17.77 to –1.53, p = 0.020), VAS pain intensity score of –10.98 (95% CI, –21.36 to –0.61, p = 0.038)
13	Pishgahi, et al. (12) 2020	RCT	Knee osteoarthritis participants age 40–75 years with radiological signs of grade II, III, and IV	DPT: 30 participants PRP: 30 participants ACS: 32 participants	DPT: 57.9 ± 1.62; PRP: 58.93 ± 1.71; ACS: 61.28 ± 1.67	Baseline, 1st month, and 6th month	Injections administered 3 times, interval 1 week The combination of 50% dextrose (2 mL), bacteriostatic water (2 mL), and 2% lidocaine (1 mL) injected intra-articularly by USG guidance	PRP Injections were administered 2 times, interval 1 week 4× concentration of platelets and the lowest leukocyte of PRP was injected intra-articularly by USG guidance. ACS Injections administered 2 times, interval 1 week 2 mL ACS injected intra-articularly by USG guidance.	Pain: VAS Functional outcome: total WOMAC	Time-point score DPT group Basal: 67.00 ± 2.50 1 month: 63.33 ± 2.47 6 month: 63.30 ± 2.92 PRP group Basal: 61.10 ± 1.21 1 month: 56.33 ± 1.021 6 month: 55.00 ± 2.27 ACS group Basal: 61.25 ± 3.44 1 month: 46.88 ± 4.45 6 month: 35.00 ± 3.51	Time-point score DPT group Basal: 65.93 ± 1.67 1 month: 71.67 ± 2.95 6 month: 72.33 ± 2.57 PRP group Basal: 60.33 ± 3.70 1 month: 46.67 ± 4.30 6 month: 45.67 ± 3.82 ACS group Basal: 56.28 ± 3.13 1 month: 49.53 ± 3.67 6 month: 34.88 ± 3.35	ACS outperformed DPT in pain and functional outcomes PRP outperformed DPT in functional outcomes, but not significantly different in pain.
14	Rezasoltani, et al. (16) 2020	RCT	Knee osteoarthritis ≥50 years old with KL grade 3 or 4	DPT: 30 participants PT: 30 participants BN: 30 participants HA: 30 participants	DPT: 64.8 ± 5.8 PT: 70 ± 6.3 BN: 67.7 ± 7.3 HA: 66.1 ± 9.1	Baseline, 1st week, 4th week, 3rd month	Injections performed 3 times, 1 month interval 8 mL 20% dextrose + 2 mL 2% lidocaine injected intra-articularly by USG guidance combined with exercise programme	PT group Participants received 20 min of superficial heat using a hot pack. Then, TENS 80−100 Hz for 100−200 ms with maximum tolerable intensity. In addition, participants received pulsed ultrasound 1 MHz, 0.8−1.0 W/cm2, 50% duty cycle, 5 min per session combined with exercise programme BN group Single-dose injection 250 units of Dysport, equivalent to 100 units of botulinum neurotoxin type A diluted with 5 mL normal saline injected intra-articularly by USG guidance combined with exercise programme HA group The injections performed 3 times, 1 week interval. 2 mL HA (Hyalgan; Fidia Farmaceutici, Abano Terme, Italy) injected intra-articularly by USG guidance combined with exercise programme	Pain: VAS Functional outcome: KOOS	Data was reported in linear model	Score changes DPT group Pain Baseline: 21.5 ± 5.9 3 months: 11.6 ± 6.8 Function, daily Baseline: 39.6 ± 14.1 3 months: 22.2 ± 16.1 Function, sports Baseline: 12.4 ± 2.0 3 months: 5.3 ± 4.3 Quality of life Baseline: 12.2 ± 1.5 3 months: 5.5 ± 3.0 PT group Pain Baseline: 21.3 ± 5.0 3 months: 9.2 ± 5.3 Function, daily Baseline: 34.7 ± 12.9 3 months: 8 ± 16.3 Function, sports Baseline: 13.0 ± 1.8 3 months: 4.3 ± 3.8 Quality of life Baseline: 10.2 ± 2.1 3 months: 3.8 ± 3.7 BN group Pain Baseline: 19.0 ± 6.5 3 months: 11.6 ± 6.7 Function, daily Baseline: 36.8 ± 10.0 3 months: 8 ± 16.3 Function, sports Baseline: 13.0 ± 1.8 3 months: 4.3 ± 3.8 Quality of life Baseline: 10.2 ± 2.1 3 months: 3.8 ± 3.7 HA group Pain Baseline: 20.2 ± 6.6 3 months: 2.1 ± 9.9 Function, daily Baseline: 33.7 ± 13.6 3 months: 2.8 ± 19.6 Function, sports Baseline: 10.8 ± 1.9 3 months: 1.2 ± 5.7 Quality of life Baseline: 9.5 ± 1.1 3 months: 1.7 ± 4.5	DPT and BN have similar effectiveness in reducing pain and improving functional outcomes. DPT outperformed PT in reducing pain, but was not significantly different in improving functional outcomes. DPT outperformed HA in both pain and functional outcomes.

RCT: randomized controlled trial; SD: standard deviation; DPT: dextrose prolotherapy; OA: osteoarthritis; KOA: knee osteoarthritis; KL: kellgren-lawrence; ACR: American college of rheumatology; DDH: developmental dysplasia of the hip; ACL: anterior cruciate ligament; BN: botulinum neurotoxin; PT: physical therapy; HA: hyaluronic acid; ACS: autologous conditioned serum; PRP: platelet-rich plasma; VAS: visual analogue scale; WOMAC: Western and Ontario McMaster Osteoarthritis Index; USG: ultrasonography; TENS: transcutaneous electrical nerve stimulation; HHS: harris hip score.