The novelty of thisstudy lies in its comparative assessment of three latest intra-articular injection therapies including steroid injections, dextrose prolotherapy, and PRP, for knee OA associated impairments, with a focus on long-term efficacy and safety profile. While prior studies may have assessed one or two of these treatments individually therefore this protocol is systematically designed.
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Parallel
Intra articular steroid injection
Procedure/SurgeryParticipants will receive intra-articular injections of corticosteroid such as methylprednisolone in order to reduce inflammation and manage pain.
Intra articular PRP
Procedure/SurgeryParticipants will receive PRP, derived from the own blood of patient, which will be processed in laboratory to concentrate platelets containing growth factors to provide support in tissue repair.
Intra articular dextrose prolotherapy
Other interventionParticipants will receive dextrose prolotherapy injections, in which a hypertonic dextrose solution that is typically 25% will be injected into the knee joint in order to stimulate joint tissue regeneration.
NPRS
The Numeric Pain Rating Scale (NPRS) is a validated, self-reported measure used to assess pain intensity. Participants rate their current knee pain on a scale from 0 to 10, where 0 indicates "no pain" and 10 represents "worst imaginable pain." NPRS scores will be recorded at baseline and at designated follow-up intervals to evaluate the effectiveness of steroid, dextrose prolotherapy, and platelet-rich plasma injections in reducing pain among patients with knee osteoarthritis.
WOMAC
The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) is a validated, disease-specific, self-administered questionnaire used to assess pain, stiffness, and physical function in patients with knee and hip osteoarthritis. It consists of 24 items divided into three subscales: * Pain (5 items) * Stiffness (2 items) * Physical Function (17 items) Each item is rated on a Likert scale (0-4) or VAS (0-100 mm) depending on the version used. Higher scores indicate greater pain, stiffness, or functional limitation. WOMAC scores will be recorded at baseline and follow-up intervals to evaluate treatment efficacy across steroid, dextrose prolotherapy, and platelet-rich plasma injection groups.
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