Cost Effectiveness of Prolotherapy Injections Prior to Total Knee Arthroplasty
Cost Effectiveness of Prolotherapy Injections Prior to Total Knee Arthroplasty
This study compared the cost effectiveness of two-stage algorithm (prolotherapy injections
 (PrT) combined with rehabilitation protocol (RP) prior to total knee arthroplasty (TKA)) and
 one-stage algorithm (TKA) in the management of advanced stage knee osteoarthritis.
The aim of the present study was to compare the cost effectiveness of two-stage algorithm
 (prolotherapy injections (PrT) combined with rehabilitation protocol (RP) prior to total knee
 arthroplasty (TKA)) and one-stage algorithm (TKA) in the management of advanced stage knee
 osteoarthritis.

 A total of 197 patients who had chronic knee osteoarthritis were included in the present
 study. The patients were divided into two groups as two-stage algorithm (PrT combined with RP
 prior to TKA), (Group A, n=98) and one-stage (TKA),(Group B, n=99). Clinical effectiveness
 was evaluated via Visual Analog Scale (VAS), The Western Ontario and McMaster Universities
 Arthritis Index (WOMAC) at baseline and 3-, 6-, 12-, and 18-month follow-ups. Utility scores
 of the groups were obtained by extracting and converting WOMAC scores to health utilities
 index mark 3 scores. Cost-utility per quality-adjusted life years (QALY) and Incremental
 cost-effectiveness ratios (ICERs) of each group were calculated.
Inclusion Criteria:

 -  III and IV levels of knee osteoarthritis according to Kellgren-Lawrence

 -  Had at least six months of symptoms resistant to at least three months of conservative
 methods (lifestyle modification, weight reduction, regular exercise, physiotherapy,
 non-steroidal anti-inflammatory drugs, intraarticular injection methods) -

 Exclusion Criteria:

 -  With rheumatic diseases, immune diseases or other systemic inflammatory diseases

 -  With active infection, osteomyelitis or history of chronic infection around knee joint

 -  Had undergone previous operation on knee

 -  Had bleeding tendency (hereditary or acquired)

 -  Pregnant patients