Prolotherapy and ESWT
A research study carried out in February 2026 (1) investigated pain and restricted movement in patients with knee osteoarthritis who exhibited weakness in their quadriceps femoris muscles. The researchers observed that this weakness arises not only from inactivity but is also affected by arthrogenic muscle inhibition, which is the body’s natural response to safeguard the joint from additional harm. Both extracorporeal shock wave therapy and dextrose prolotherapy have been recognized as potential treatments for this condition. The study assessed the effectiveness of these treatments in enhancing quadriceps femoris strength in individuals with grade II–III knee osteoarthritis. A total of twenty-two patients were divided into two groups: one group underwent six weekly sessions of ESWT, while the other group received three injections of dextrose prolotherapy at three-week intervals. Following the treatment, both the ESWT and Prolotherapy groups demonstrated significant enhancements in the strength of the quadriceps femoris muscle. Further examination indicated that dextrose prolotherapy was more beneficial for patients with grade II osteoarthritis, although it did not show increased effectiveness for those with grade III osteoarthritis.
Nugroho AB, Arfianti L, Wardani NK, Atika, Pratiwi N. Comparison of the effects of dextrose prolotherapy and extracorporeal shockwave therapy on quadriceps femoris muscle strength in patients with knee osteoarthritis. Health, sport, rehabilitation. Published online February 18, 2026. doi:10.58962/HSR.1341
