AfterThe accurate diagnosis of osteoarthritis (clinical and radiographic) , And evaluation of patient inclusion &exclusion criteria for the study, Details of treatment is described and the patient's written consent is obtained.Other drug treatments (NSAID, corticosteroids and other anti-inflammatory drugs) and non pharmacological (knee physiotherapy modalities are included, TENS, laser, etc.) will be discontinued 48 hours before the start of the intervention. Then initial knee x-ray is taken. And according to radiographic criteria, grading is done and initial patient questionnaire is completed.Then knee joint range of motion (ROM) measured by Goniometr &Medial and lateral joint line tenderness is reviewed & Pain intensity on VAS (state separation as the rest, walking, sitting, etc.) And according to the WOMAC questionnaire is assessed. The grouping is done, the other person does the first Hyalgan injections and hypertonic dextrose or 20% .A total of 3 patients were injected into the knee joint to be considered. Injections in patients treated with Hyalgan, at intervals of one week (vials 2 ml prepared hyaluronic acid) and in patients treated Prolotherapy three injections at intervals of one month (compound 9 ml of glucose 20% with 1 cc of lidocaine 2% in a syringe 10 cc) is done. After injection, it is recommended that patients have a relative rest for 48 hours, it increases the duration of maintaining and enhancing the response to treatment. for sterility , sterile gloves & sterile infusion sets are used. Before each injection, patients were reassessed for pain (VAS and a questionnaire based on numerical criteria WOMAC), range of motion, tenderness of the joint line (medial and lateral) and injection complications (infection, Hemartrosis,...) are checked.
Patients can be followed during the course of the pain, take acetaminophen 325, But the 12 hours prior to treatment to follow, do not use acetaminophen. After treatment protocol (three injections and in each stage of the assessment), range of motion, pain and joint line tenderness is measured.